Provisional CBT Training Enquiry
Select date from the online calendar, please avoid completing on a mobile phone
Title:
Mr
Miss
Mrs
Ms
Dr
Other
Full Name:*
Contact Number:*
Your email address:*
Address:
Town/City:
Postcode:
Prov/Driving Licence No:
Gender:
Female
Male
Other
Age:*
Height in FT:
License Type Held:
Provisional
Car
Car Driver:
YES
NO
Course:
CBT ( 1 day communal) £100
CBT ( 2 day communal) £240
CBT Plus - 1 day just you and the instructor £240
CBT2 Plus - 2 day just you and the instructor £480
Prefered Course Date ( Select free space from calendar ):
CBT Location:
Newton Abbot
CBT Bike:
Please Select
My Own 50cc Auto
My Own 50cc Geared
My Own 125cc Auto
My Own 125cc Geared
Hired 50cc Auto +£40
Hired 125cc Geared +40
.................................................
Have you previously had a CBT:
YES
NO
Previous CBT Date:
Previous CBT Schools Name:
.................................................
Riding History:
Health / Learning Issues:
Comments, licence points / disqualifications:
.................................................
Name of person completing form if not student:
Relation to student if your not the student:
Reason student is not the applicant:
.................................................
I have read the
CBT Page
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