Wallace School - Booking Service - Client information

1.	Company Name:
	Company Address:
	What is the nature of your business?
	Contact name and business title
	Tel. No:
	Fax. No:
	Mobile No:
	E-Mail Address:
2.	Please arrange assessment lesson at Wembley for: LGV C1, 7.5 tonne LGV C (formerly HGV 2/3) LGV C+E (formerly HGV 1)
3.	Please state most suitable time and date: (for assessment) time day month year
4.	And approximately when driver training is required:
5.	Driver's Full name:
6.	Driver's Home Address:
7.	Driver's Home tel. no:
8.	Driver's Mobile no:
9.	Please indicate where you would prefer to take driver training: Wembley (any vehicle) Heathrow (LGV C & C+E only) Enfield (LGV C & C+E only)
9.	And approximately when driver training is required:
10.	UK Licence No: as xxxxx - xxxxxx - xxxxx - -
11.	Provisional applied on/ or if you are waiting for your provisional, what date did you apply for it?
	Full or Provisional Categories held
	Expiry Date:
12.	Please arrange 'Web Booking' Discount rate for: Assessment Lesson £20.00 Assessment Lesson + 3 DSA Books £45.00
13.	We will phone to acknowledge receipt of your E-mail and ask for your credit card details or your method of payment for this booking, and confirm date and time of the lesson.
This booking is subject to Wallace School of Transport Conditions of Trading. To view click here
Wallace School of Transport Unit 5a Pop-In Building, South Way, Wembley, Middx HA9 0HF Tel: 020 8902 9498 Fax: 020 8903 1376 We will acknowledge your booking by return and forward receipt for your payment.