DEFENSIVE DRIVING COURSE APPLICATION

 
 

 

Full name as stated on your licence

 
 

please make sure this is a number you can easily be contacted on.

 
 

Please put your full address including area (eg: Waipukurau, Waipawa, Otane etc)

 

Date of birth

 
dd/mm/yyyy
 

Click as many as applies

 

 
  • Course cost $250
  • You must come to all 4 sessions and complete the practical drive at the end to get your defensive driving certificate
  • You need to have your restricted licence already to attend
  • $50 non refundable deposit needs to be paid to confirm your spot upon completing this sign up
  • Instalments are accepted, but the balance needs to be paid in full before the start of the course
  • Cancellations may be no later than 3 working days before the course begins, otherwise a cancellation fee may apply



BANK ACCOUNT DETAILS

02 0780 0042411 00

Please put your last name as reference and DDC as code


Please tick that you've read and understood this information

 
 

This is on the back of your licence

 

Please include photos of the front & back of your current drivers licence. Photo needs to be clear enough to get your licence details

Drop your files here
 

Please select the course that works best for you.


It will be 4x sessions 5 - 7pm over a few weeks and then a practical drive to be arranged. You must attend all sessions.

 

Please let us know if there is any further information you want us to know about you or how you learn. This information will be held in the strictest confidence.


For example:

  • learning difficulties
  • anxiety
  • Asperger's
  • ADHD
  • hearing difficulties
  • health concerns
  • have been in an accident in the past
  • or anything else you think we should know.