In-car Request Form For BDE Students

In-Car Instructor Request

First Name (legal name as it appears on driver's license)

Last Name (legal name as it appears on driver's license)

Phone

Receipt Number

Receipt Number 2 (if applicable)

Address

Postal Code

Automatic Course or Manual Shift Course?

Automatic Course Manual (Shift Gear) Course

When are you eligible to take your road test?

Preferred Driving Instructor

First Name

Last Name

Please mention the area you live in

Preferred Instructor Gender

Male Female No Preference

What time of day are you available?

Days	Morning	Afternoon	Evening
Monday
Tuesday
Wednsday
Thuresday
Friday

Comments / Questions

NOTE:

If you wish to cancel any course you have registered for, you will be charged administration fees once you have paid.
Admin fees for online course is $150 + tax Admin fees for in-person course is $75 + tax

Quick Links

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Locations

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