Michelin Tires Race Contingency

2011 "Team Michelin" Contingency Enrollment

Rules

Welcome to the Team Michelin contingency enrollment process. Enroll now to be eligible to receive contingency awards for select events accross the nation. Simply complete the form below to enroll in the program, pending approval by Michelin.   Michelin Privacy Policy

Note: All fields marked with [ * ] are required. Your valid social security number is required for tax reporting purposes. Supplying incorrect information will result in non-payment of contingency earnings.


Personal Info

*

First Name

*

Last Name

*

Date of Birth

*

E-mail:

*

SSN/SIN/Tax ID:

  Required for tax purposes

*

Phone:

*

Address Line 1:

 

Address Line 2:

*

City:

*

Country:

*

State/Region:

 

*

Postal Code:

 

Account Activation - $49.95 USD

*

Credit Card Type

*

Credit Card Number

*

Expiration Date

*

CVV2


This is the 3 or 4 digit number on the back of your credit card.

 

Your credit card will not be billed immediately. You will only be billed after the 7 day acceptance period.

 

 

XTRM Info

 

If you are an existing XTRM member, please provide your Username and Account Number for faster enrollment.
* Your XTRM Account number begins with PAT.

 

XTRM Username:

 

XTRM Account No.:

 

Already have a Pro Card?   Yes  View Card

 

Competition Info

Team Name:

AMA Member No.:

*

Competition No.:


This is the number you use during competition on your vehicle, number plate, or yourself.

 

Alternative No.:

 

 

 

Michelin Privacy Poicy

 

*

I Agree to Terms & Conditions

 

 

Terms & Conditions