Apply for Provisional Driving License

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Provisional Licence Information

What identity document do you have? This will be used to confirm your identity. *

UK Resident
Non-UK Resident

Enter the document identity number *

Please choose one: *

UK Passport
Non UK passport
Biometric Residence card
Biometric Residence permit
National identity card

Non-UK Resident: Which document did you use to apply for an online immigration status from the Home Office? *

Non UK passport
Biometric Residence card
Biometric Residence permit
National identity card

Have you had a provisional licence before? *

Please provide the Full Name as appeared on provisional *

Please provide Address as appeared on provisional *

Address Line 1

Address Line 2

City

State / Province / Region

Country

Have you been disqualified or had your licence revoked? *

Have you lived in another European Union or European Economic Area country other than the UK in the last 12 months? *

In which European Union or European Economic Area country have you lived in the last 12 months?

What date did you come to live in the UK? *

Are you currently disqualified from driving in the UK (including Northern Ireland, Jersey, Guernsey and Isle of Man) or any other country? *

Disqualification date *

Court Name *

Do you need to wear glasses or corrective lenses to meet this standard? *

Can you read a number plate from 20 metres and confirm that you have not been advised by an optician or doctor that your eyesight does not meet the minimum standards for driving? *

with glasses or corrective lenses if necessary?

Can you meet the legal eyesight standards for driving using glasses or corrective lenses if needed? *

Details of the legal standards required by law can be found here: https://www.gov.uk/driving-eyesight-rules

Are you currently claiming any of the following benefits? *

Yes
No, I am not claiming any of these benefits

Adult Disability Payment (ADP) The mobility part of ADP at the enhanced rate, Child Disability Payment (CDP) The mobility component of CDP at the higher rate, Disability Living Allowance (DLA) The mobility part of DLA for children at the higher rate, Personal Independence Payment (PIP) The mobility part of PIP at the higher rate

Do you suffer from any medical conditions that may impact your ability to drive? *

Yes
No, I confirm that I don’t suffer from any medical condition that would impact my ability to drive.

Medical Conditions *

Diabetes controlled by insulin (No need to notify us if you have diabetes controlled by tablets or other injections unless you experience hypoglycaemia requiring the assistance of another person)
Epilepsy
Any condition affecting both eyes, or the remaining eye if you only have one eye. Not including colour blindness or short or long sight
Stroke, with any symptoms lasting longer than one month or TIAs
Fits or blackouts
Any type of brain surgery, severe head injury involving in-patient treatment, or brain tumour
An implanted cardiac defibrillator (ICD)
An implanted cardiac pacemaker
Repeated attacks of sudden disabling giddiness
Any other chronic neurological condition including Multiple Sclerosis, Motor Neurone and Huntington’s disease
A serious problem with memory or periods of confusion
Persistent alcohol misuse or dependence
Persistent drug misuse or dependence
Serious psychiatric illness or mental ill health
Parkinson’s disease
Sleep apnoea syndrome
Narcolepsy
Any condition affecting your visual field
Total loss of sight in one eye
Any persisting limb problem which needs driving to be restricted to certain types of vehicles or those with adapted controls
Severe learning disability

Title

Name *

First

Middle

Last

Birth Last Name *

Multiple Choice *

Male
Female

Date of Birth *

Place of Birth *

Country of Birth *

Mother's Maiden Name (Surname before marriage) *

Your Address Information

Current Address Information

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How long have you lived at current address?

Is your Current address the same as prevoius address? *

Previous Address Information *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Security Information

choose Birth Birth

Passport Number *

National Insurance Number *

Email *

Phone *

Payment Information

Price *

Price: £54.00

Stripe Credit Card *

Apply for Provisional Driving License

Provisional Licence Information

Your Address Information

Security Information

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