Intensive Driving Booking Form

Payments are not taken through this form.

Personal Information

Full Name

Full Address with postcode for licence

Full Address with postcode to be picked up from for lessons

Date of Birth (dd/mm/yyyy)

Mobile Number

Email Address

Provisional License

Have you got a Provisional License? —Please choose an option—YesNo

Provisional License Number (On line 5 of your licence card)

If No, Have you sent off for a Provisional License —Please choose an option—YesNo

If Yes, Please confirm date posted

If No, When are you likely to complete the form for your Provisional License

Driving Experience

Have you driven before? —Please choose an option—YesNo

If Yes, How many hours experience

Which type of Vehicle (Auto/Manual) —Please choose an option—ManualAutomatic

General Information

Is there a date you need to pass by:

What date would you like to start on:

What times would require for intensive course?

Do you require any special requirements (eg ADHD,Dyslexia,Dyspraxia or anything else)

Manual / Automatic Intensive Course

Which intensive course did you wish to be considered for: —Please choose an option—10 Hours14 Hours20 Hours25 Hours32 Hours40 Hours

Visit our price page for more explanation on the intensive course including week day practical driving test.

Do you require us to book a Theory Test —Please choose an option—Yes + £45No

Theory

Have you passed your Theory Test —Please choose an option—YesNo

If Yes, When did you pass your Theory Test (date)

If Yes, when does this run out (date)

If Yes, Please provide Theory Test Certificate Number

If No, when is your theory booked confirm date / time / place Time: Place

Do you require us to book a Theory Test —Please choose an option—Yes + £45No

Would you like week day or Saturday booking for theory test —Please choose an option—Week DaySaturday

Which centre would you like to take your theory test at

Practical Driving Test

Have you got a driving test booked —Please choose an option—YesNo

If Yes, can you confirm date / time / place Time: Place

If No, please confirm your 1st,2nd,3rd choice where you would like to take your practical driving test (Test Centre)

Have you got to have an extended practical driving test? —Please choose an option—YesNo

If Yes, what was the reason for behind this? (Additional costs will apply)

Do you require a Saturday or Bank Holiday practical driving test —Please choose an option—SaturdayBank Holiday

If Yes additional cost will apply

Have you ever taken a test before —Please choose an option—YesNo

If Yes, How many have you taken

When did you fail

What was the reason why you failed?

Additional Information

Is there any other information to help us choose the right intensive driving course for you and your needs?