JAG AllStars - Club Membership Payment
 

Thank You for joining JAG AllStars Club and becoming part of the real change.

To make a secure online donation, please fill in the form below, after which you will be re-directed to a secure payment page.

We only accept donations in Rand value. To do a currency conversion, please visit http://www.xe.com/ucc/

 

Personal Details
(please complete all sections. Fields marked with * are required. )
Title
Name *
Surname *
Telephone (landline) *
Telephone (cell) *
Email Address *
Delivery Address *
(deliveries during business hours only)
Postal Code *
Gender
Date of Birth *
( eg. dd/mm/yyyy )
Reference *
( i.e. how did you hear about JAG ALLSTARS )
(Please be sure to complete all fields)
T-shirt Order details*
(R150 includes T-shirt & delivery charge, we are sorry but no international deliveries)
T-Shirt
I would like to purchase JAG AllStars T-shirt in size:
None
Male Cut
Female Cut
Slim Fit
Standard Fit
Please Select Size
 
Sponsorship details:
I would like to support (select one box)
1 Future SuperStar Child
2 Future SuperStar Children
3 Future SuperStar Children
4 Future SuperStar Children
Payment Details:
Total Amount:
Payment frequency:
Once Off
Annually
(When you click Submit, you will be redirected to our secure payment page. Thank you.)
I agree with general terms and conditions


MEMBERSHIP BENEFITS



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