Chance Cars
Name*
Date of Birth* (dd/mm/yyyy)
Contact number* (home)
Contact number* (mobile)
Email*
Do you hold a Reigate and Banstead private hire or hackney carriage licence? YesNo
Do you own your own licensed vehicle? YesNo
Is your vehicle licensed by Reigate and Banstead? YesNo
Do you have any relevant qualifications? (NVQs, etc…) YesNo
Are you a member of any professional driver/chauffeur organisations? YesNo
Do you hold a Blue Badge? (These are badges issued by Surrey County Council, allowing you to work with children & vulnerable people) YesNo
Do you have any health issues? YesNo
Since the age of 16, have you spent more than 3 months abroad? YesNo
Work History (5 years)*
Work Reference (Current or Previous Employer)
Position*
Address*
Telephone number*
Relationship to you*
Signature*
Date* (dd-mm-yyyy)
