DRIVER NUMBER IS COMPULSORY YOUR APPLICATION FORM CANNOT BE PROCESSED WITHOUT THIS

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APPLICATION FORM PRACTICAL DRIVING TEST FOR OFFICIAL USE ONLY APPLICATION. Using a credit or debit card you can apply for your driving test online at www.rsa.ie When you have completed the application form, please detach this page and forward it together with the correct fee to the Road Safety Authority (RSA) at the address shown below. Fees are set out in point 9 of the accompanying information notes. If you have not received an acknowledgement within two weeks, please contact The (contact details below). Any personal information which you volunteer on this application will be treated by the RSA strictly in accordance with the Data Protection Acts, 1988 &2003. (Please complete in BLOCK capitals) 1. Details DRIVER NUMBER IS COMPULSORY YOUR APPLICATION FORM CANT BE PROCESSED WITHOUT THIS What is your Driver Number? (see note 7 on page 5) If you are a first time learner permit holder, you cannot take a driving test until 6 months after the issue date of the permit for a car, motorcycle or works vehicle. (see note 7 on page 5). For details on Learner Driver Training requirements for all first time learner permit holders see note 8 on page 5. Category BE and bus and truck categories are exempt from this requirement. TITLE: Mr Mrs Miss Other (please state) SURNAME: FIRSTNAME: CURRENT ADDRESS: TOWN: COUNTY: DATE OF BIRTH: DAY MONTH YEAR GENDER: MALE FEMALE DAYTIME PHONE NUMBER: MOBILE PHONE NUMBER: We may use texts from time to time to remind you about your test appointment and other application information E-MAIL ADDRESS: Do you want us to correspond with you, e.g. to acknowledge your application and notify you of appointment date by EMAIL or by POST (please tick one box only) If you select email, please check your email account regularly, as we will send your test appointment details via email only. You should ensure that DriverTestingSection@rsa.ie is on your safe senders list. PERSONAL PUBLIC SERVICE NUMBER (PPSN): (see note 3 on page 4) If you have received lessons from an Approved Driving Instructor (ADI), please provide their permit number: (See note 13 page 5). 1 of 5

2. Type of Application [a] In which licence category do you wish to be tested? (see note 1 on page 3) (Please note that you can only apply for a test in respect of one licence category on this form) (If you are applying for a bus or truck test, please also complete section 2[k]) [b] Which driving test centre do you want to be tested at? (see note 4 on page 4 ) [c] Please advise of any period when you are unavailable to sit a driving test. (see note 5 on page 4) [d] In certain cases cancellations may become available. Are you free to take a cancellation slot at short notice? (see note 5 on page 4) [e] Have you previously taken a driving test in any licence category? If, please give the approximate date of the test. DAY MONTH YEAR [f] What is the restriction code(s) on your learner permit shown under item 12? (see note 7 page 5) Restriction code(s) [g] Do you have a disability which requires you to drive a specially adapted vehicle? (see note 6 on page 5) [h] Are you deaf or do you have a hearing difficulty for which you require assistance? (see note 6 on page 5) [i] Do you wish to have your test conducted through the Irish language? [j] Any other relevant information about your application. [k] Bus or Truck Test [i] If you are applying for a test in any of the bus or truck licence categories (C, C1, D, D1 etc) please state if you are applying for a Driver Certificate of Professional Competence (Driver CPC). (See note 2 on page 4) If No, please state why [ii] If you have answered Yes above, do you want both the driving test and the practical knowledge test scheduled for the same day? (see note 2 on page 4) [iii] If you have already passed one part of the Driver CPC test and now want to take the other part please state which part you are applying for. (see note 2 on page 4) Part 1 [Driving Test] Part 2 [Practical Knowledge Test] 3. Declaration by Applicant I hereby apply for a driving test and I declare that the information I have given in this application is correct. I understand that to give false or misleading information is an offence. If within 14 days of this application you choose to withdraw your application for a driving test, you may seek a refund (see note 10 on page 5) SIGNATURE: DATE: 2 of 5

APPLICATION FORM INFORMATION PRACTICAL DRIVING TEST PLEASE READ TES CAREFULLY BEFORE COMPLETING YOUR APPLICATION FORM 1. Driver Licence Categories Licence Category AM A1 A2 A B BE W C CE C1 C1E D DE D1 D1E Vehicles in Licence Category Mopeds. Light quadricycles. Motorcycles with an engine capacity not exceeding 125cc, with a power rating not exceeding 11 kw and with a power to weight ratio not exceeding 0.1 kw/kg. Motor tricycles with a power rating not exceeding 15 kw. Motorcycles with a power rating not exceeding 35 kw, with a power to weight ratio not exceeding 0.2 kw/ kg and not derived from a vehicle of more than double its power. Motorcycles. Motor tricycles. Vehicles (other than motorcycles, mopeds, work vehicles or land tractors) having a MAM 1 not exceeding 3,500 kg, designed and constructed for the carriage of no more than eight passengers in addition to the driver and where the MAM 1 of any trailer is not greater than 750 kg. The combined MAM 1 of the drawing vehicle and trailer must not be greater than 3,500 kg. Quadricycles (other than those covered by AM) also come under this category. Combination of drawing vehicles in category B and trailer where the MAM 1 of the trailer is not greater than 3,500 kg. Work vehicles and land tractors. Vehicles (other than work vehicles or land tractors) having a MAM 1 exceeding 3,500 kg, designed and constructed for the carriage of no more than eight passengers in addition to the driver and where the MAM 1 of any trailer is not greater than 750 kg. Combination of drawing vehicles in category C and trailer where the MAM 1 of the trailer is greater than 750 kg. Vehicles in category C having a MAM 1 not exceeding 7,500 kg, designed and constructed for the carriage of no more than eight passengers in addition to the driver and where the MAM 1 of any trailer is not greater than 750 kg. Combination of drawing vehicles in category C1 and trailer where the MAM 1 of the trailer is greater than 750 kg and where the MAM 1 of the drawing vehicle and trailer combined does not exceed 12,000 kg. Combination of drawing vehicles in category B with trailer where the MAM 1 of the trailer is greater than 3,500 kg and where the MAM 1 of the drawing vehicle and trailer combined does not exceed 12,000 kg. Vehicles designed and constructed for the carriage of more than eight passengers in addition to the driver and where the MAM 1 of any trailer is not greater than 750 kg. Combination of drawing vehicles in category D and trailer where the MAM 1 of the trailer is greater than 750 kg. Vehicles in category D designed and constructed for the carriage of no more than 16 passengers in addition to the driver, with a maximum length not exceeding 8 metres and where the MAM 1 of any trailer is not greater than 750 kg. Combination of drawing vehicles in category D1 and trailer where the MAM 1 of the trailer is greater than 750 kg. 1 Maximum Authorised Mass (also known as Design Gross Vehicle Weight D.G.V.W) means design laden weight. Manufacturers generally refer to it as gross vehicle weight (g.v.w.) and it is usually displayed on a metal plate attached to the vehicle by the manufacturer. For a motorcycle driving test, a sidecar is not permitted for test purposes except in the case of a person with a disability. To take a driving test in a vehicle with a trailer, you must hold a full licence for the drawing vehicle e.g. in order to take a test in category BE, you must hold a full B licence and a learner permit for BE. You must provide the vehicle for the driving test. We will inform you of the vehicle specifications and type of vehicle required in your appointment notification for the test. 3 of 5

2. Driver Certificate of Professional Competence From 10 September 2008 in the case of a bus driver and 10 September 2009 in the case of a truck driver you must hold a Driver Certificate of Professional Competence (Driver CPC) to work as a professional driver. If you wish to drive either a truck or bus professionally and you didn t hold a full driving licence (before 10 September 2008 for a bus or 10 September 2009 for a truck) either for the vehicle you want to drive or some other vehicle in that vehicle category, you must take an extended two part driving test (see below) to qualify for the Driver Certificate of Professional Competence. If for example you held a C1 or D1 licence before the above dates and now want to drive either a category C or D professionally, you need only take and pass the normal driving test and get the full licence in the relevant category. You will also need to have completed the relevant 5 CPC training modules in order to drive professionally. The bus or truck driving test lasts approximately 90 minutes, while part two, the CPC Practical Test, is a test of knowledge, lasting approximately 30 minutes, covering aspects of driver safety and proper procedure. These tests can be scheduled separately on different dates or together on the same day as requested by the test applicant. Before taking the CPC Practical Test a person must pass both the normal driver theory test and a special two part Driver CPC theory test. A person who is taking a bus or truck driving test and does not plan to drive professionally but decides to do so at a later date can take Part Two of the test to qualify for Driver CPC provided this (and the necessary Theory Tests) is done within a two year period. You must provide a PPSN in all cases when applying for a Driver CPC. For more information on Driver CPC including details of drivers exempt from the rules please visit www.rsa.ie and click on the Driver CPC link under the Professional Driver icon. 3. PPSN The Personal Public Service Number (formerly RSI number) is your unique reference number to help you to access benefits and information from public service agencies. If you do not know your PPSN you should contact your local office of the Department of Social Protection. Staff in this office will assist in tracing your number or in the event that you do not have a PPSN, will arrange for one to be assigned to you. New applicants for PPSN will be asked to produce documentary proof of identity and residence in Ireland. 4. Test Centres Driving test centres are located countrywide as set out in the table below. Athlone Dundalk Naas Ballina Dungarvan Navan Birr Ennis Nenagh Buncrana Galway Newcastle W. Carlow Gorey Portlaoise Carrick-on-Shannon Kilkenny Roscommon Castlebar Killarney Shannon Cavan Kilrush Skibbereen Clifden Letterkenny Sligo Clonmel Cork Donegal Dublin City Churchtown Finglas Tallaght Raheny *You may be tested at either test centre. You may choose to be tested at any one of these test centres and as far as possible your test will be scheduled for the centre you nominate. Driving tests for Motorcycles, Trucks and Buses are not conducted at every test centre. If you apply for a test in these licence categories you will be scheduled at the test centre closest to you, where those tests are conducted. If you visit www.rsa.ie you can view a site map and waiting times for each centre. If you are applying for a test in category W (tractor/works vehicle) you can request to have the test conducted at a town nearer to you than any of the above centres and every effort will be made to facilitate you. 5. Availability *Limerick City Castlemungret Woodview Longford Loughrea Mallow Monaghan Mullingar Thurles Tipperary Tralee Tuam Tullamore Waterford Wexford Wicklow The aim of the is to have an average of a ten week waiting time for driving tests at all test centres. From time to time waiting times will be longer or shorter, depending on demand for tests at individual test centres. If you are not available at some point, you should note this on the application form. If, following applying for the test, you become aware of a period where you are not available, please notify us. Up to date waiting times, by test centre, are available at www.rsa.ie. Cancellations become available, often at short notice and if you are prepared to take a test with notice from as little as two days and up to ten days, please indicate this at 2(d) on the application form. 4 of 5

6. Disability or Hard of Hearing If you have a disability and use a car that is adapted to enable you to drive, please let us know as soon as possible by ticking the relevant box at 2(g) of the application so that appropriate arrangements can be made for you on the day of the test. If you are deaf or have a hearing difficulty, please let us know at 2(h). You will be asked a number of questions on the rules of the road at the beginning of the test; to help us make arrangements and to help you with instructions for the test on the day you can bring along a relative or a friend, but not a driving instructor. This person cannot however accompany you on the driving part of the test. 7. Learner Permit The learner permit was previously known as the provisional licence. The driver number is a nine digit number indicated on the learner permit at 4(d). The learner permit restriction code is a three digit number e.g. 991, 992 on your learner permit, under item 12. In order to take a driving test, you must hold a learner permit for the licence category in which you wish to be tested. A first time holder of a learner permit (permit will have code 991 noted in the restrictions column) for licence categories AM, A1, A2, A, B and W (Motorcycle, Car and works vehicle) must hold the learner permit for six months before taking the test. Category BE and bus and truck categories are exempt from the 6 months requirement. A holder of a current full driving licence from another jurisdiction for more than 6 months is also exempt. In such a case, before undergoing a driving test, you must forward a letter of entitlement from the relevant licensing authority together with your driving licence to the Customer Service Manager, Driver Testing Section, RSA, Ballina, Co Mayo where your licence will be verified and a test appointment arranged for you if appropriate. In certain circumstances, you can only hold a learner permit if you already hold a full driving licence for a smaller/ lighter vehicle. Before applying for the test, you should ensure that you hold the correct learner permit. Eligibility for a third or subsequent learner permit for any category of vehicle is dependent on you having taken a driving test within the previous two years or providing confirmation that a test appointment has been arranged for you in the vehicle category in question. For more information on learner permits or if you have any doubt about your eligibility for a learner permit you should visit www.ndls.ie. 8. Learner Driver Training As part of a programme of improving driving standards and safety on our roads, all first time learner permit holders in the motorcycle and car categories are required to undertake structured Learner Driver Training. Cars: Those taking out a first time car learner permit (permit will have code 991) have to take structured lessons. Car learner drivers must complete a training programme known as Essential Driver Training (EDT) with an Approved Driving Instructor (ADI) before taking a driving test. The course is 12 hours for car licences. Please note that we cannot schedule your test until your ADI has uploaded all 12 lessons, via our EDT portal. You may check the status of this in the My EDT portal on the RSA website. Motorcycles: In the case of a motorcycle learner driver it applies to those taking out a first learner permit (permit will have code 991). Motorcycle learners must complete a training programme known as Initial Basic Training (IBT) with an Approved Driving Instructor (ADI). IBT must be completed before going on the road unsupervised with a motorcycle. The IBT course lasts for 16 hours. Information about EDT and IBT is available at www.rsa.ie and can be accessed by clicking on the Learner Driver link. You can also view a list of Approved Driving Instructors under the ADI link. 9. Driving Test Fee Your application must be accompanied by the correct fee for each test licence category. These are set out hereunder and are non-transferable and non-refundable. Payment should be made by postal order, money order or cheque, crossed and made payable to the. DO T SEND CASH. Applications accompanied by an incorrect fee will be returned. For administrative reasons, no refunds will be made in respect of E2 or less in excess of the fee for the category concerned. Categories AM, A1, A2, A, B, BE and W 85 Categories C, C1, D and D1 120 Categories CE, C1E, DE, D1E 120 CPC Driving Test (Bus and 152 [Part 1-120] Truck Category) [Part 2-32] 10. Withdrawal of Test Application If within fourteen days of the RSA receiving your driving test application, you wish to withdraw that application, you may request to do so and seek a refund of the application fee. Forms for this purpose are available online at www.rsa.ie or by contacting us directly. 11. Cancellation of Test Appointment Test appointments are normally issued four to five weeks before the date of the test. The aims to have an average of a ten week or shorter waiting time for a driving test. You should be mindful of this when applying and preparing for your driving test. You will find details of waiting times for test centres at www.rsa.ie. A minimum ten days notice of a cancellation must be given, otherwise the fee is forfeited. If you cancel your appointment more than twice the test fee will be forfeited. 12. Irish Language To have your driving test conducted through the Irish language, you must indicate this preference by ticking the Yes box in question 2(i). 13. Test Preparation To prepare for your driving test you should study the Rules of the Road booklet which can be purchased from bookshops or visit www.rulesoftheroad.ie, take driving lessons with an Approved Driving Instructor (ADI) and practice under the supervision of a competent accompanying driver (see note 8 page 5). You can view a list of Approved Driving Instructors (ADIs) by visiting the Learner Driver Section at www.rsa.ie. Each Approved Driving Instructor has an ADI permit number (eg. F11111), which is on the card displayed in their vehicle. 14. Customer Care The is committed to continually improving its services and welcomes feedback. If you want to give feedback, make a complaint, or give a compliment, please write to the Customer Service Officer, Driver Testing Section,, Moy Valley Business Park, Primrose Hill, Ballina, Co. Mayo. You can also make contact by locall 1890 40 60 40, by email to drivingtest@rsa.ie or on our website at www.rsa.ie. 5 of 5

Working To Save Lives Rev. September 2017