Driving Lessons Form
If you are not registered with Waitaha please go onto our website to do so. https://waitaha-iwi.org.nz/iwi-register/ NB: Please note- we do not fund resits.
Full Name
*
First Name
Last Name
Date of Birth
If you are under 18, who is your Waitaha parent you would be registered under?
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
What license do you hold?
What is your license number:
Would you be able to take lessons In Te Puke?
*
Please Select
Yes
No
Applicants Identification:
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Signature
Conflict of Interest: Do you have any Conflicts of Interests to declare? Are you related to anyone in the Office or on the Sub-Committee I.e: Spouse, Sibling, Parent, Child or 1st cousin?
Yes
No
Please name all COI's here:
Submit
Should be Empty: