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WHEELS IN MOTION GAWLER
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Participant Information
Please provide details of the learner driver.
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
Upload supported file (Max 15MB)
Logbook hours completed
Number of driving instructor lessons completed
Transport to Cafe Nova
*
Required
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
*
Required
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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