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Village Minibus Driver Registration Form
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* Indicates required question
Full Name as Appears on Driving Licence
*
Your answer
Email
*
Your answer
Address
*
Your answer
Phone number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Next of Kin Name
*
Your answer
Next of Kin Contact Number
*
Your answer
Driving license number
*
Your answer
Date Driving Licence Obtained
*
MM
/
DD
/
YYYY
Any motoring convictions in last 5 years
*
Yes
No
Motoring Convictions (date, points received, offence code)
Your answer
Any Motoring Accidents in last 5 years
*
Yes
No
If yes, were you deemed at fault?
Yes
No
Other:
Clear selection
Motoring Accident details
Your answer
Reference number having completed the form on this link:
https://www.gov.uk/view-driving-licence
*
Your answer
I Agree to comply with Minibus Operating Policy:
http://btckstorage.blob.core.windows.net/site10264/Membership%20rules.pdf
*
Yes
Required
I Agree to Inform Tirley Parish Council as soon as any of the above information changes
*
Yes
Required
I agree that I will not share the Key Box number with any other person, without the express permission of Tirley Parish Council
*
Yes
Required
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