Learner Driver Signup Form Please enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth: *Enter D.O.B in format: DD-MM-YYYYGENDER: *FEMALEMALEDRIVERS LICENCE / PERMIT NUMBER *Are you comfortable driving a manual vehicle? *YESNONot SureLet us know if you can drive a manual car without assistance...COURSE: *PLEASE SELECTAutomatic LEARNER DRIVERManual LEARNER DRIVERHGV LEARNER DRIVERPLG LEARNER DRIVERPlease select CourseADDRESS: *CONTACT NUMBERS: *Please enter contact numbers separated by comma(,).OCCUPATION *Email *EmailConfirm EmailPREFFERED START DATE: *PREFFERED START TIME: Comment or Message *REASON FOR TAKING COURSE: *DO YOU HAVE ANY MEDICAL CONDITIONS THAT WOULD HAMPER YOUR PARTICIPATION? *YESNOIF YES, PLEASE EXPLAIN: *WHAT WOULD YOU LIKE TO GAIN FROM THIS COURSE? *I authorise Barbados Driver Training Advisory Services (BDTAS) to take, use and copy photographs and films of me at the Training Course without objection or charge including commercial use thereof. ** I Agree* I Disagree*Photos and or Videos taken, may be used on our websites, social media pages and magazines for training or promotional purposes. HOW DID YOU HEAR ABOUT US? *FacebookGOOGLEInstagramRadio AdvertTwitterWord of MouthWorkDATE: *By ticking this box you agree to be bound by our "Terms of Service" You will be required to Sign the Program Rules & Indemnity Waiver, in the presence of our staff. *I AgreeCommentSubmit
