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COURSE REGISTRATION

  
Please read the Terms & Conditions before filling out the registration form.
*Last Name:

*First Name:

Middle Name:

*Gender:

*Date of Birth:

 / /

Address:

Apt. or Unit:

City:

Postal Code:

*Home Number:

Bus. or Cell Number:

Email Address:

Driver's Licence #:

*Licence Class:

Expiry Date:

 / /

Course Date:

*see schedule
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*I have read and agree to the Terms & Conditions.
   
   *These fields must be completed
Please note: Submitting this registration form does not guarantee entry to a course.
You are required to put a deposit of $300.00 on the course to confirm your acceptance.
You may come to our office or phone and make payment arrangements or email us
if you have further questions at ondrivingschool@bellnet.ca.

 
  Location:
 
  366 Oxford Street East
  Suite 3B

  Phone Number:
 
  (519) 673-4360
 

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