Join cityhop

cityhop individual membership application

Fill out this form (all fields are REQUIRED) and click button at the bottom of the page to submit details.
Upon receipt of your personal details we will send you a confirmation email and a cityhop team member will contact you to confirm your ID and collect your payment details.
After billing details have been confirmed you will receive a letter containing your password and cityhop car access card.

Billing Address
First Name:
Last Name:
Password:	(minimum length 6 characters - 2 characters must be numerals eg. test01)
Date of Birth (dd/mm/yy):
Sex:
Day Phone:
Evening Phone:
Mobile Phone:
Email:
Confirm Email:
Home Address
Street:
Suburb:
City:
Postcode:
Postal Address (if different to home address)
Street:
Suburb:
City:
Postcode:
Licence Information
Licence Number:
Issued By (eg NZ):
Expiry Date (dd/mm/yy):
Number of Years Driving:
Insurance Declaration
cityhop offers an insurance excess reduction option (for details click here) - would you like to purchase excess reduction?
I have read and accept the cityhop terms and conditions (for details click here)
Additional Member Information (optional)
Name:
Licence Number:
Issued By (eg NZ):
Expiry Date (dd/mm/yy):
Additional Information
Do you currently own a car?
If yes, estimated kilometres driven annually
How did you hear about cityhop carshare?
If other, please specify:
Additional information, questions or comments:
Please click "Submit new membership" button to submit your application. Please be patient as your application may take a few moments to process.