DEFENSIVE DRIVING NORTH SHORE
9 Ponderosa Drive Browns Bay Auckland 0632
Email:- colin@defensivedrivingnorthshore.co.nz

THE NEW ZEALAND DEFENSIVE DRIVING COURSE
REGISTRATION FORM

Full Name as shown on Licence *
 
 
Address/Physical (Not P O box) *
 
Phone (Work/Mobile) * Home
 
Date of birth *
 
Licence Number * Restricted
 
Date Licence Issued *
 

1 Mon. 27th. February
2 Wed. 29th. February
3 Mon. 5th. March 
4 Wed. 7th. March

1 Tue 20th. March
2 Thur. 22nd. March
3 Tue. 27th. March
4 Thur. 29th. March
Pay by Friday 24th February           Pay by Friday 16th March

 

How would you like to pay?*                 
$190.00 for the full course, including the in-car session.
                

Cash  Cheque  Internet Banking  ANZ Takapuna A/C Name:- Defensive Driving North Shore, 01 0274 0136714 00
                
   

 

Payment Method:- $190.00, Cheque/Cash/Internet Banking. Eftpos or credit card not available.

If paying by cheque/cash please deliver or post, prior to attendance & make cheques payable to:- Defensive Driving North Shore. Payment confirms your registration.