Career Driven Preferred Provider Application

4 copy Driving

Section 1 - Business Details

Please provide the details of your business and the primary contact person for communication.

ABN *

Australian Business Number

Business Name *

Primary Contact Name *

Primary Contact Email *

Primary Contact Phone Number *

Business Address *

Address Line 1

City

State / Province / Region

Postal Code

Section 2 - Service Information

Lesson types offered: *

VORT only
CBT&A only
VORT and CBT&A

Minimum lesson time: *

Fee for a 60 minute lesson: *

Please detail how much is charged for a 60 minute lesson. If you do not offer 60 minute lessons, please put N/A.

Fee for a 90 minute lesson: *

Please detail how much is charged for a 90 minute lesson. If you do not offer 90 minute lessons, please put N/A.

Fee for a 120 minute lesson: *

Please detail how much is charged for a 120 minute lesson. If you do not offer 120 minute lessons, please put N/A.

Surcharges and additional fees

The career driven covers the cost of driving lessons only, any surcharges must be disclosed and will be taken into consideration in our assessment process.

Please select if an additional fee is charged on any/all of the following: *

Detail other surcharges:

Weekend surcharge: *

Public Holiday surcharge: *

Regional surcharge: *

Manual surcharge: *

Out of school hours surcharge: *

VORT and final drive

Do you offer Vehicle on Road Tests (VORT)? *

How much do you charge for a VORT? *

Do you offer a Final Drive? *

How much do you charge for the Final Drive? *

Packages / special offers

Please advise of any packages, special offers and/or discounts.

Please advise of any packages or special offers:

Availability

Please detail the days, hours and regions that your services are offered.

Days of operation: *

Hours of operation: *

Please advise which areas you service in South Australia *

Cancellation Policy

Please detail your cancellation policy.

Please detail your cancellation policy: *

Section 3 - Compliance and Supporting Documentation

What type of Motor Driving Instructor are you: *

Motor Driving Instructor (no flash)
CBT&A Authorised Examiner (yellow flash)
VORT Authorised Examiner (red flash)

Provide a copy of your current motor driving instructor's (MDI) licence: *

Click or drag files to this area to upload. You can upload up to 2 files.

MDI Expiry Date: *

Provide a copy of your Working With Children Check (WWCC): *

Click or drag files to this area to upload. You can upload up to 2 files.

Section 4 - Displayed Information

If approved, your details will appear on the doorways2construction website. Be sure to include any helpful contact information so students can easily get in touch with you.

Displayed Contact Number:

If this is the same as the primary contact information above you can leave this blank

Displayed Email Address:

If this is the same as the primary contact information above you can leave this blank

Displayed Website / Socials:

Additional Information

Please detail any additional information that you would like considered to be included on the website. E.g. is there an option for female trainers?

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

Declaration *

The information I have provided within this form is true and correct
My business details will be shown on the doorways2construction website, if approved
I have read and agree to the Career Driven Terms and Conditions for Preferred Providers
I have read and agree to the Career Driven Inclusions and Exclusions for Preferred Providers
I have read and agree to the Career Driven Invoicing Guidelines for Preferred Providers