Peak hours - intensive driving course application form
Training to be completed during peak hours - Evenings and Weekends
Name as appears on driving licence
*
Prefix
First Name
Last Name
Address
*
House No. & Street name
Area
City / County
State / Province
Post Code
Above address is this same as your driving licence?
*
Yes
No
Address that appears on your driving licence
*
Street Address
Area
City
State / Province
Post code
E-mail
*
Phone number
*
Driving licence number
*
e.g BROWN123456TP9DT
Your date of birth
*
Have you pass your theory test
*
Yes
No
Theory certificate number
*
e.g BROWN123456TP9DT
Date theory test expires
*
-
Day
-
Month
Year
Date Picker Icon
Date of theory test booking (if applicable)
-
Day
-
Month
Year
Date Picker Icon
Would you like help booking your driving test?
*
Yes - We will help you to book a driving test at the end of your Intensive course
No - You will need to have a test already booked. Please get in touch with us for our availability before completing this form if the test is less than 6 weeks away, and the test fee will be deducted from the total price
What is the date of the driving?
*
Time of the driving test?
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Name of the Driving test centre?
*
Assessing Instructor (if applicable)
Manual or Automatic car
*
Manual car
Automatic car
Which Intensive course
*
Please Select
10 Peak hours Intensive course
16 Peak hours Intensive course
20 Peak hours Intensive course
26 Peak hours Intensive course
34 Peak hours Intensive course
42 Peak hours Intensive course
Additional Information
Deposit
*
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Deposit for Intensive course - peak hours
£220.00
£
220.00
Total
£0.00
£
0.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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