Pitstone Community Car Scheme

VOLUNTEER DRIVER CAR DETAILS REGISTRATION FORM
			
YOUR DETAILS

Title:  MR/MRS/MS

Surname	First name	

Address		

	 Post Code	

LICENCE DETAILS

License Number: _______________________________           

Expiry date: _______________________________           

License Check Code: ____________________________    

This allows us to check your license following the abolition of the paper counterpart. Please create this on the government website https://www.gov.uk/view-driving-licence 
If you are unsure how to do this, the co-ordinator will be happy to help.                                        

Endorsements: Yes/No

If yes, please give details:______________________________________________________

CAR DETAILS

Registration number(s):________________________________________________________

Insurance company: __________________________________________________________

Policy number:______________________________                                                            

Renewal date: ______________________________

MOT Expiry date/first date due: _______________________

Please return this form to the co-ordinator, along with copies of your:

•	Current car insurance
•	Driving licence