Application for a Driver Theory Test Application for …

1 Application Applicationforfor Application afor Driver Theory aaDriver Driver Test Theory CPC Bus orTest Truck Car (B)/Motorcycle (A, A2, A1), Moped (AM), Tractor/Work Vehicle (W), Truck (including Step Theory Test 1 of Car (B)/Motorcycle Driver (A, A1)/Moped CPC) (C), Bus (AM), StepTractor/Work (including(Certificate 1 of theof Vehicle Driver of Driver CPC) (CD), Bus Module (BMT) or Truck Module (TMT). CPC)(W), Truck (D), Professional (C) or Bus (including Truck&Bus Competence (D) Note )1. Note You Youcan cannow now book book online online at at Please Note: A separate Please Note: A separate form You The can Thefee fee now forfor bookCPC. a Category a Driver online AM, Bus Cat BW, oror D Theory Truck TestTest Theory is (Part 1: form is required for CPC.)

2 Partfor2:CPC Case is required ). Applications. Study The The fee fee for a for a Bus bothAM, Category & Truck BW, BMT = C, DTest & TMTcombined is = = Step 2 Applications. TOBOOK. TO BOOKPHONE. PHONE 1890. 1890 To606. 606 106 106. Book (Lo-call (Lo call PHONE rate)Rate). 1890 Text Text 106 Phone 606 Phone 1890 616. (Lo-call 1890. 216616. Rate) or 216. L n L ne irithinte TEXT PHONE irithinte tr Ghaeilgetr . 1890 616 Ghaeilge 1890. 216606 8061890 606 806. OurOur operators operators are are available available fromfrom n . to L ne Monday Monday irithinte to Friday Friday totr 6:00pm Ghaeilge to 1890 606test to book to book your 806and your test and immediately confirm your Our operators immediately are your confirm available from Monday appointment.

3 Appointment. to have Friday Please Please have your your Credit toCard Credit and to Card book and PPSN to your PPSN to test hand. immediately confirm your appointment. Please have your Credit/Debit Card, PPSN, Learner Permit or Driving Licence to hand. (Note 5). Please Pleaseread Please readboth read bothsides both sidesof sides ofthis of thisform this formand form andcomplete completethe form theform formin in BLOCK. inBLOCK CAPITALS. BLOCKCAPITALS. CAPITALS. Personalpublic Personal publicservice servicenumber number (PPS Number) Driver Driver Driver number number number (in BLACK. (in BLACK. (in BLACK PRINT on5paper PRINT item PRINT. licence on your 9 numbers or 4d Permit). Learner on on card). your licence). Personal public service number (PPS No.)

4 MANDATORY MANDATORY MANDATORY. FOR C, D, CD, BMT & TMT. MANDATORY MANDATORY FOR CATEGORY C & D Application . Stock number (in RED PRINT 1 Letter + 7 numerals on your Learner Permit). CATEGORY OF TEST CATEGORY BW. (TICK ONE ONLY) CATEGORY. MANDATORY OFVehicles Cars, Work TEST& Land (TICK Tractors ONE ONLY). CATEGORY AM CATEGORY BW. CATEGORY AM CATEGORY CD CATEGORY D. CA TEGORM otorcycles Motorcycles Y. & Mopeds& Mopeds OF TEST. Truck & Bus Cars, Theory TestWork (PleaseVehicles & Land Bus Theory Tick) *Multiple Tractors Test Choice Questions (MCQ). CATEGORY C CATEGORY D. CATEGORY C (*MCQ) (Part 1) 72 (*MCQ) (Part 1) 72. CATEGORY BMT BUS & TRUCK. CATEGORY TMT (*MCQ) (Part 1) 72. BUS Trucks TRUCK Buses Truck Theory Test Bus Case Studies (Part 2) 72 Bus Module Test Truck Case Studies (Part 2) 72 Bus & Truck Truck CaseModule Studies (Parts Test 2 combined) 144.

5 PLEASE. PLEASENOTE. YOUR. YOURDETAILS. DETAILS contact NOTEthe contact1890. thedate 1890606. datethat 606106. thatyou youpost 106 IMMEDIATELY. postyour yourapplication. Failuretotodo dososocould after14. 14days couldresult daysyou youhave resultininLOSS. haveNOT. LOSS ofoffee NOTreceived feeor receivedan ormissed anappointment appointment confirmation, missedappointment appointment.(Note confirmation, please (Note2). 3). Title TitleMs/Miss/Mrs/Mr Ms/Miss/Mrs/Mr First FirstNames Names Surname Surname Gender Gender M/F. Address Address Date of Date Birth Bi Day of Birth Day Month Month Year Year Country of Birth Daytime Tel. No. Bi County County Daytime Tel. No. Bi Country Country Email IFIFPROVIDED, PROVIDED,CONFIRMATION.

6 CONFIRMATIONWILL. WILLBE. BEBY. BYEMAIL. EMAILONLY. ONLY. Mobile Mobile Tel. No. Bi Tel. No. Bi Email CONFIRMATION. CONFIRMATION TEXT TEXT. PROVIDED 24 PROVIDED. HOURS PRIOR TO TEST DATE. Wherewould Where wouldyou youlike liketototake takeyour yourtest? test? (See(Note 2) overleaf (Note 1). locations Whatis isthe What theearliest earliestdate dateyou youwould wouldbebe able able to to take take your your test? test? Please Please allowallow 10 days 10 days for postal for postal Application .(Note Application 7 & 10). (Note 6 & 10) Day Day Month Month Year Year If If thetheabove abovedate dateis isnot notpossible, possible,a atest testwill willbebebooked bookedfor foryou youon onthe theclosest closestpossible possibledate.)

7 Allowus usto tobook book aa date date and and time time that that is is best best for for you,wewerecommend you, recommendyou youbook bookon-line alternativelyby bytelephone telephoneusing usingthe thenumber number at at the the top top of of this this form. form. DoIf you you have have aa special special need need or or disability disability that that may may require require special special arrangements arrangements to to take take your yourtest , dyslexia,or otherreading, other readinghearing or or hearing difficulties, language additional difficulties Note 9support Pleasecan notebeifprovided, you require extended support, time. Youyouwillwill need to send need medical to send medicalevidence from evidence a school, from a school, doctorororemployer doctor employerononheaded headedpaper papertogether togetherwithwiththis thiscompleted completedapplication applicationform.

8 Uponreceipt receiptwe we will will contact contact you you toto make make the the arrangements arrangements or foror for further further information information you Email you may may Email (Please Tick). (Please Tick). Please ticktick if youifwould like to listen like to the test to the test Irish (Note English Polish English Russian Lithuanian Please you would listen through headphones in one of 8) Irish through headphones in the onefollowing of the languages. following languages. Irish / English / Polish (All categories) (Note 9). Russian / Lithuanian (Category BW ONLY). CREDIT/DEBIT CARD DETAILS. CREDIT/DEBIT. I wish CARD DETAILS. to pay by Mastercard/Visa. Please charge my account. My card number is: I wish to pay by Mastercard/Visa.

9 Please charge my account. My card number is: Expiry Date Please charge to my account Expiry Date Please charge to my account Remember, with a Credit Card or Voucher you can bookRemember, online immediately at www. with a Credit Card you can book online immediately at www. Title Name of card holder Signature of card holder Date Title Name of card holder Signature of card holder Date Day Month Year Day Month Year PAYZONE VOUCHER Voucher Number Expiry Date Day Month Year DETAILS (Note 6). You can now book online at 1. Driver Theory Test Centres Test may be taken at the following centres: Abbeyfeale Cork Killarney Skibbereen Athlone Derrybeg Letterkenny Sligo Ballina Donegal Limerick Tullamore Caherciveen Drogheda Longford Youghal Carric on Shannon Dublin Central Macroom Waterford Carlow Dublin North Monaghan Westport Castlerea Dundalk Mullingar Wexford Cavan Ennis Naas Wicklow Charleville Galway Nenagh Clifden Navan Portlaoise Clonmel Kilkenny Tralee 2.

10 Make a note of the date you post your Application and if after 14 days you have not received an appointment notification, please contact 1890 606 106 (Lo call rate) immediately. If you don't you may miss your appointment and lose your fee. 3. Web Bookings: 4. Phone Bookings: Call 1890 606 106 (Lo call rate) and have your PPS number (formally RSI), Credit/Debit Card details or Payzone Voucher to hand and Driving Licence if you have one. If you are not the card holder, the card holder must be present to authorise the use of the card. 5. Fax Bookings: Fax this completed Application to 1890 606 906. 6. Postal Bookings: Send this completed Application form with your postal order or cheque to the following address: Driver Theory Test, Po Box 788, Togher, Cork.