Authorised Drivers 2019/20
Last Name *
First Name *
Date of Birth *
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Date of test passed *
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Email Address *
Contact Number *
Student ID *
If you are a staff member write 'Staff'
Please tick the following vehicles you have experience driving - Please email activities@leeds.ac.uk with any MIDAS certificates *
Please be aware that you must hold a MIDAS or a D1 qualification to drive a large van, MPV or Minibus
Required
Club/Department *
Please DO NOT use acronyms or you will be required to complete the form again.
DVLA code *
This can be obtained from www.viewdrivingrecord.service.gov.uk/driving-record/licence-number If you hold a licence abroad please state that country.
Last 8 digits of Driving License Number *
Captionless Image
Are you happy to be contacted by other Clubs/Societies to drive for another group? *
Have you ever been refused motor insurance? *
Do you have any medical conditions that we should be made aware of? *
Please write N/A if not.
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