Registration

Personal Information

First name * Last name * Date of Birth * DDMMYYYY

Gender * Male Female

Home phone * Business (cell) phone Licence # Date of Issue DDMMYYYY

Street No & name* Apt # City * Postal Code * Email Nearest Intersection How did you hear about us? Fields marked with an * as REQUIRED

1.I certify that the statements in this document are accurate and consent to the release of any information contained herein to the Ministry of Transportation, Insurance Bureau of Canada and the MTO Course Inspector.

2.I understand that this course has to be completed within 1 year. Otherwise, the fee is non-refundable.

3.In-car lessons are provided from Monday to Friday (7am - 4pm).

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