Career Driven Preferred Provider Application

Please provide the details of the primary contact person for communication.

Business Name *

ABN *

Australian Business Number

Business Contact Name *

Business Contact Email *

What are your hourly charge rates? *

Do you have a manual car surcharge? *

What is the manual car surcharge ($)? *

How much do you charge for the Vehicle On Road Test? *

Do you offer a package of driving lessons and a VORT? *

Please detail what is included in your package and the cost?

Do you offer a logbook package? *

Please detail what is included in your logbook package and the cost?

Please upload a copy of your Drivers Instruction License *

Click or drag files to this area to upload. You can upload up to 5 files.

This is for CITB records only.

If successful, your details will be viewable on the D2C website. Please detail who you would like participants to contact for driving lessons.

Phone Number *

Email *

Website / URL / Facebook link

Please check which areas in SA that you service? *

Service Areas - Additional Comments

Please let us know if there are any service restrictions in the service areas you have selected.

Additional information to be included on the website:

Would you like your logo displayed? *

Please upload your logo

Click or drag a file to this area to upload.

Please note this will be displayed next to your information. Your image will be sized to fit our website - JPEG, PDF ONLY

Declaration *