07939310057 [email protected]

Home
About
Courses
Enquiries
Instructor Area
FAQ’s

Registeration form

Personal Information

(Before filling in this form please make sure any details you include are factual and that you disclose information as necessary. This can be seen in the Terms& Conditions about the importance of the form being filled in)

Full Name

Date of Birth (DD/MM/YYYY)

Address

City

Postal Code

Phone Number

Email Address

Driving Information

Driver's License Number (if applicable)

Have you taken any driving lessons before?

YesNo

If yes, how many hours and when?

Do you have any driving-related offences?

YesNo

If yes, please elaborate

What type of transmission are you familiar with?

AutomaticManualNone

Any known driving-related issues or medical conditions?

YesNo

If yes, please describe

Are you on any medication that could affect your ability to drive?

YesNo

If yes, please list medication

Any allergies?

YesNo

If yes, please describe

Emergency Contact Information

Emergency Contact Name

Relationship to You

Emergency Contact Phone Number

Any other information you feel we need to know

Consent for Processing Personal Data

Your Name

Date

I,hereby give my consent to Drive Pro to process my personal data as provided in this form for the purpose of enrolling in and receiving driving lessons. I understand that this information will be used for matters related to my driving education with the allocated driving instructor and not shared with unauthorised third parties without my explicit consent, except as required by law.

I agree to the Terms and Conditions and Privacy Policy of Pro Pass Intensive

Parent/Guardian Signature (if under 18)

Date

© Copyright Drive Pro Intensives. | Site Map | Terms & conditions | Privacy Policy

High Quality Web Page Design