Harrisons Driver Sign Up
Name
*
First Name
Last Name
Date of Birth
*
/
Day
/
Month
Year
Date
Address
*
Street Address
Street Address Line 2
Town/City
County
Postcode
Email address
*
Phone Number
*
Were you referred by another driver? (If yes, please enter their name/driver number)
Are you currently licensed with a local authority?
*
Yes
No
Which local authority are you licensed with?
*
Private Hire / Hackney Driver Badge
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Badge Expiry Date
/
Day
/
Month
Year
Date
DVLA Plastic Driving License (front)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
DVLA Driving License Expiry
*
/
Day
/
Month
Year
Date
Do you have a licensed vehicle?
*
Yes
No
Vehicle Number Plate
Vehicle Insurance Document
Browse Files
Drag and drop files here
Choose a file
Cancel
of
PHV PLATE
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you have an up-to-date DBS?
*
Yes
No
Up-to-date DBS
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Bank Account Holder Name
*
Name of Bank
*
Sort Code
*
UK Bank Account Number
*
Submit
Should be Empty: