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Apply Now Name: Company Name: Date of Birth: ( DD/MM/YYYY ) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 Drivers Licence #: Email: Phone: Address: Have you attended a Passrite course before: No          Yes Course: Please Choose Car - Class 1 - PRICE: $60 Per hour Truck - Class 2 - Has a learners licence - PRICE: $810.00 Excluding GST Truck - Class 2 - Requires learners licence - PRICE: $900.00 Excluding GST Class 2F to 4L Time Saver Course-Eliminates the time period between licences - PRICE: $250 Excluding GST Truck - Class 4 - Has Logbooks (US 24089) - PRICE: $765.00 Excluding GST Truck - Class 4 - Requires Logbooks (US 24089) - PRICE: $820.00 Excluding GST Truck & Trailer - Class 5 - Has a learners licence - PRICE: $1045.00 Excluding GST Class 4F to 5L Time Saver Course - Eliminates the time period between licences - PRICE: $250 Excluding GST Truck & Trailer - Class 5 - Requires a learners licence - PRICE: $1150.00 Excluding GST Motorcycles - Class 6 - PRICE: $160.00 Excluding GST Forklift F Endorsement Course Only - PRICE: $185.00 Excluding GST Forklift Operators Competency Course Only - PRICE: $185.00 Excluding GST Forklift F Endorsement & Operator Competency Course - PRICE: $230.00 Excluding GST Hi-Ab Operator Competency Course - PRICE: $230.00 Excluding GST I Endorsement (Driving Instructor) - PRICE $3825.00 Excluding GST Workplace Assessors Course - PRICE: POA (Price On Application) D Endorsement (Dangerous Goods) - PRICE: $245.00 Excluding GST P Endorsement (Buses, Limo, Dial A Drivers & Shuttles) - PRICE: $430.00 Excluding GST P Endorsement with Area Knowledge (Taxi) - PRICE: $900 Excluding GST Area Knowledge Only (Taxi) - PRICE: $525.00 Excluding GST Rollers Tracks & Wheels RTW Endorsement - PRICE: $430.00 Excluding GST Street Talk - PRICE: $173.34 Excluding GST DriverSafe - PRICE $88.89 Excluding GST 4WD Course - PRICE $355.56 Excluding GST Course Location: Please Choose Auckland Hamilton Albany Fiji Course Time: Next Available Course In 2 Weeks In 3 Weeks In 4 Weeks In 5 Weeks In 6 Weeks Comments: Payment: Credit Card      Internet Banking      Cheque      Will Pay at Passrite Card Type: Visa Card Master Card Card Number: Card Holder Name: Card Expiry Date: ( MM/YY ) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / 2010 2011 2012 Please post the cheque to: PO Box 13387, Onehunga 1061, Auckland Please transfer the money to our National Bank Account: 06 0101 0976010 00   Capcha: Give me another image