.
DMA Program Booking Form
Fill out and Submit this form to reserve a place in a Driving Management Australia program. An email will be sent to your nominated email address to confirm your reservation and to give you payment instructions.
Program Type:
Defensive Driving
Program Date:
Monday, 4 October
Venue:
Mt. Cotton
Name:
*
E-mail:
*
Gift Certificate No.
(if applicable)
:
Street Address:
*
Suburb & State:
*
Post Code:
*
Daytime Phone:
*
*
= Required Field
I understand that my money will not be refunded if I cancel or postpone my booking inside 8 days of the course date. Non-attendance on the day will result in forfeiture of payment. The vehicle I will be using on the day will be registered and roadworthy.
Please press once only.