In-car Request Form For BDE Students

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In-car request form for BDE students

If you live outside of the Ottawa region or not sure if your area is located in Ottawa, please call the office to get more information and to register.

Please note: There will be a difference in pricing due to the distance.

Please register with the student's information that is taking the course.

In Car Instructor Request

Fill out the information below to request an in car instructor.

Name (As it appears on your G1/G2) *

First

Last

Email *

Phone *

Receipt Number *

Receipt Number 2 (if applicable)

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Automatic Course or Manual Shift Course? *

Automatic Course
Manual (Shift Gear) Course

What time of day are you available?

	Morning	Afternoon	Evening
Monday	Monday Morning	Monday Afternoon	Monday Evening
Tuesday	Tuesday Morning	Tuesday Afternoon	Tuesday Evening
Wednesday	Wednesday Morning	Wednesday Afternoon	Wednesday Evening
Thursday	Thursday Morning	Thursday Afternoon	Thursday Evening
Friday	Friday Morning	Friday Afternoon	Friday Evening
Saturday	Saturday Morning	Saturday Afternoon	Saturday Evening
Sunday	Sunday Morning	Sunday Afternoon	Sunday Evening

When are you eligible to take your road test?

Preferred Driving Instructor

First

Last

Please mention the area you live in *

Preferred Instructor Gender

Male
Female
No Preference

Comments / Questions

NOTE:

If you wish to cancel any course you have registered for, you will be charged administration fees once you have paid.

Admin fees for online course is $150 + tax

Admin fees for in-person course is $75 + tax

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