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WHEELS IN MOTION GAWLER

Rotary Club of Gawler Light Inc.

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First name

Last name

Email

Phone

Birthday

Address

Gender

Man

Woman

Non-binary

Transgender

Prefer not to say

Other:

Please self-describe

Do you have any medical conditions or take any medications we need to be aware of?

Copy/Photo of your Learner's Permit

Upload File

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Logbook hours completed

Number of driving instructor lessons completed

Transport to Cafe Nova

I can get to Cafe Nova

I need collecting from Gawler Railway Station

I need collecting from school (Xavier or GDC only - during school hours)

Are you currently studying?

Are you currently employed?

Please tick all that apply to you

I do not have regular access to a qualified licenced driver in the household

I do not have regular access to a suitable vehicle

I am under financial hardship

I am of Aboriginal or Torres Strait Islander background

I have recently arrived in Australia

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