Motorcycle Rider Training - Application Form

Application Date

1.0 BIO DATA

1.1 Surname (Block Letters)

1.2 Other Names (Block Letters)

1.3 Address

1.4 Tel

1.5 Email

1.6 Date of Birth

1.7 National Identity Card No.

1.8 Academic Background

2.0 COURSE APPLYING FOR

3.0 DRIVING LICENSE DETAILS

3.1 Driving License No.

3.2 Valid (Full) Driving License for Vehicle Type(s)

3.3 Provisional (Learner) Driving License for Vehicle Type(s)

3.4 Passed Oral Test at Police Traffic Branch?

Yes No

3.5 License ever endorsed/suspended?

Yes No

3.6 Any serious disease, disability or mental disorder?

Yes No

3.7 Convicted or charged for crime/motoring offence?

Yes No

3.8 If 'Yes' to any of 3.5-3.7, please give details

MAURITIUS INSTITUTE OF TRAINING AND DEVELOPMENT