PRACTICAL DRIVING TEST - RSA.ie

1 APPLICATION FORMU sing a credit or debit card you can apply for your DRIVING test online at you have completed the application form, please detach this page and forward it together with the correct fee to the Road Safety Authority (RSA) at the address shown below. Fees are set out in point 9 of the accompanying information notes. If you have not received an acknowledgement within two weeks, please contact The Road Safety Authority (contact details below). Any personal information which you volunteer on this application will be treated by the RSA strictly in accordance with the Data Protection Acts, 1988 & NUMBER IS COMPULSORY YOUR APPLICATION FORM CANNOT BE PROCESSED WITHOUT THISWhat is your Driver Number?

2 (see note 7 on page 5)If you are a first time learner permit holder, you cannot take a DRIVING test until 6 months after the issue date of the permit for a car, motorcycle or works vehicle. (see note 7 on page 5). For details on Learner Driver Training requirements for all first time learner permit holders see note 8 on page 5. Category BE and bus and truck categories are exempt from this :FIRSTNAME:CURRENT ADDRESS:TOWN:COUNTY:TITLE: Mr Mrs Miss Other (please state) DATE OF BIRTH:GENDER:DAYTIME PHONE NUMBER:MOBILE PHONE NUMBER:If you select email, please check your email account regularly, as we will send your test appointment details via email should ensure that is on your safe senders list.

3 PERSONAL PUBLIC SERVICE NUMBER (PPSN): (see note 3 on page 4)If you have received lessons from an Approved DRIVING Instructor (ADI), please provide their permit number: (See note 13 page 5).MALEDAYYEARMONTHFEMALE(Please complete in BLOCK capitals)1. DetailsPRACTICAL DRIVING TEST1 of 5E-MAIL ADDRESS:We may use texts from time to time to remind you about your test appointment and other application information dar s Um Sh bh ilteacht Ar Bh ithreRoad Safety AuthorityAn Rann g T st la Tiom na, P irc Ghn Ghleann na Muaidhe, Cnoc an tSabhairc n,B thar Bhaile tha Cliath, B al an tha, Co.

4 Mhaigh EoDriver Testing Section, Moy Valley Business Park, Primrose Hill, Dublin Road, Ballina, Co. Mayolocall: 1890 40 60 40 email: web: OFFICIAL USE ONLYAPPLICATION you want us to correspond with you, to acknowledge your application and notify you of appointment date by EMAIL or by POST (please tick one box only)2. Type of Application[k] Bus or Truck Test[a] In which licence category do you wish to be tested? (see note 1 on page 3) (Please note that you can only apply for a test in respect of one licence category on this form)(If you are applying for a bus or truck test, please also complete section 2[k])[b] Which DRIVING test centre do you want to be tested at?

5 (see note 4 on page 4 )[c] Please advise of any period when you are unavailable to sit a DRIVING test. (see note 5 on page 4)[d] In certain cases cancellations may become available. Are you free to take a cancellation slot at short notice? (see note 5 on page 4)[e] Have you previously taken a DRIVING test in any licence category?[f] What is the restriction code(s) on your learner permit shown under item 12? (see note 7 page 5)Restriction code(s) _____ [g] Do you have a disability which requires you to drive a specially adapted vehicle?

6 (see note 6 on page 5)[h] Are you deaf or do you have a hearing difficulty for which you require assistance? (see note 6 on page 5)[i] Do you wish to have your test conducted through the Irish language? YES NO[j] Any other relevant information about your application.[i] If you are applying for a test in any of the bus or truck licence categories (C, C1, D, D1 etc) please state if you are applying for a Driver Certificate of Professional Competence (Driver CPC). (See note 2 on page 4)[ii] If you have answered Yes above, do you want both the DRIVING test and the PRACTICAL knowledge test scheduled for the same day?

7 (see note 2 on page 4)If No, please state whyIf YES, please give the approximate date of the NOYES NODAYMONTHYEARYES NOYES NOYES NO[iii] If you have already passed one part of the Driver CPC test and now want to take the other part please state which part you are applying for. (see note 2 on page 4)YES NOPart 1 [ DRIVING Test]Part 2 [ PRACTICAL Knowledge Test]3. Declaration by ApplicantI hereby apply for a DRIVING test and I declare that the information I have given in this application is correct.

8 I understand that to give false or misleading information is an within 14 days of this application you choose to withdraw your application for a DRIVING test, you may seek a refund (see note 10 on page 5)SIGNATURE: DATE:2 of 5 dar s Um Sh bh ilteacht Ar Bh ithreRoad Safety AuthorityAn Rann g T st la Tiom na, P irc Ghn Ghleann na Muaidhe, Cnoc an tSabhairc n,B thar Bhaile tha Cliath, B al an tha, Co. Mhaigh EoDriver Testing Section, Moy Valley Business Park, Primrose Hill, Dublin Road, Ballina, Co. Mayolocall: 1890 40 60 40 email: web: FORM INFORMATIONPLEASE READ NOTES CAREFULLY BEFORE COMPLETING YOUR APPLICATION FORM1.

9 Driver Licence CategoriesMopeds. Light CategoryVehicles in Licence CategoryA1A2 ABCEC1C1 EDDED1D1 ECombination of drawing vehicles in category B and trailer where the MAM1 of the trailer is not greater than 3,500 kg. Vehicles in category C having a MAM1 not exceeding 7,500 kg, designed and constructed for the carriage of no more than eight passengers in addition to the driver and where the MAM1 of any trailer is not greater than 750 kg. Vehicles designed and constructed for the carriage of more than eight passengers in addition to the driver and where the MAM1 of any trailer is not greater than 750 kg.

10 1 Maximum Authorised Mass (also known as Design Gross Vehicle Weight ) means design laden weight. Manufacturers generally refer to it as gross vehicle weight ( ) and it is usually displayed on a metal plate attached to the vehicle by the a motorcycle DRIVING test, a sidecar is not permitted for test purposes except in the case of a person with a disability. To take a DRIVING test in a vehicle with a trailer, you must hold a full licence for the drawing vehicle in order to take a test in category BE, you must hold a full B licence and a learner permit for BE.