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** Note** Your application will only be progressed if your driver licence is currently active and you have held it for the last three months without any period of suspension or disqualification.

Applicant Details

Family name
Given name
Residential address
Mailing address (if different from above)
Your mobile number
Your date of birth
Email address
Your driver licence number

Driving Experience

Provide a brief description what basic car handling skills you have developed during your L1 stage.

What is the approximate number of hours of driver learner training you have completed to date?

Medical Declaration

Do you have:
(You must select an option for each question)
  • heart disease?
  • sleep apnoea?
  • frequent fainting?
  • giddy attacks?
  • epilepsy?
  • diabetes?

    (If so, how is your diabetes controlled?)

Do you have any other medical condition or physical or mental disability which may affect your driving?

Do you need to use prescription glasses or contact lenses when driving?
Have you had a fit or convulsion in the last 5 years?

Personal information protection statement

You are providing personal information to the Registrar of Motor Vehicles, who will manage that information in accordance with the Personal Information Protection Act 2004 and relevant provisions of the Act. The personal information collected here will be used by the Registrar of Motor Vehicles for driver licensing and vehicle registration purposes, and related purposes under the Act and associated laws, including for national identity.

The Registrar of Motor Vehicles may also use the information for related purposes, or disclose it to third parties in circumstances allowed for by law. You have the right to access your personal information by request to the Registrar of Motor Vehicles and you may be charged a fee for this service.