Driving Ahead – Sign Up Form
Please complete the details below. This will help us to make sure that we do
our best to support your needs and help you to get the most out of the
course.
Name
Address
Phone Number
Email
National Insurance Number
How would you rate your skills and
confidence with numeracy?
How confident are you at driving
theory?
How would you rate your skills and
confidence with literacy?
Do you have a provisional licence?
Have you sat the theory test before?
Have you sat the hazard perception
test before?
Have you used driving software
before?
I find it very difficult
There’s some things I find hard
I would like to brush up on my skills
I feel quite confident
I feel very confident
Not at all confident
A little confident
Quite confident
Very confident
I find it very difficult
There’s some things I find hard
I would like to brush up on my skills
I feel quite confident
I feel very confident
Yes/No
Yes/No
Yes/No
Yes/No
What do you hope to get out of
coming on the course? (Tick as many
boxes as you like)
Help to pass your theory test
To learn about road safety
To improve your numeracy skills
To gain confidence
To meet new people
To improve your literacy skills
Other (give details)
You will get support from our tutors both in the kitchen and to do other
activities. However, you may feel you need some extra help. What additional
support, if any, will you need to come on the course?
From our tutors
From others (including key workers)
Please tell us about any additional
support needs, disability or medical
condition that we should be aware of
e.g. do you need help with learning,
mobility, hearing, etc?
Key Worker Contact Details (if relevant)
Name
Organisation
Email
Phone number
1-1
reading support
1-1
kitchen support
1-1
numeracy support
A crèche
Any other help (give details)
Someone to support you to come on
your first day
Help getting to and from the group
each week
Any other help (give details)