Have you lived in another European Union or European Economic Area country other than the UK in the last 12 months? *YesNo
What date did you come to live in the UK?* Day12345678910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear20022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950
In which European Union or European Economic Area country have you lived in the last 12 months?*
Are you currently disqualified from driving in the UK (including Northern Ireland, Jersey, Guernsey and Isle of Man) or any other country? * YesNo
Disqualification date* Day12345678910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear20022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950
Can you meet the legal eyesight standards for driving using glasses or corrective lenses if needed? *Details of the legal standards required by law can be found here:https://www.gov.uk/driving-eyesight-rules
Can you read a number plate from 20 metres and confirm that you have not been advised by an optician or doctor that your eyesight does not meet the minimum standards for driving? *
with glasses or corrective lenses if necessary?
Do you need to wear glasses or corrective lenses to meet this standard? *YesNo
If you have a medical condition we may need further information from you or your doctor to confirm that you meet the medical standards of fitness to drive. When you have completed your application it will go to the medical department for consideration
Diabetes controlled by insulin (No need to notify us if you have diabetes controlled by tablets or other injections unless you experience hypoglycaemia requiring the assistance of another person)EpilepsyAny condition affecting both eyes, or the remaining eye if you only have one eye. Not including colour blindness or short or long sightStroke, with any symptoms lasting longer than one month or TIAsFits or blackoutsAny type of brain surgery, severe head injury involving in-patient treatment, or brain tumourAn implanted cardiac pacemakerAn implanted cardiac defibrillator (ICD)Repeated attacks of sudden disabling giddinessAny other chronic neurological condition including Multiple Sclerosis, Motor Neurone and Huntington's diseaseA serious problem with memory or periods of confusionPersistent alcohol misuse or dependencePersistent drug misuse or dependenceSerious psychiatric illness or mental ill healthParkinson's diseaseSleep apnoea syndromeNarcolepsyAny condition affecting your visual fieldTotal loss of sight in one eyeAny persisting limb problem which needs driving to be restricted to certain types of vehicles or those with adapted controlsSevere learning disability
Please enter your First Name and Middle Name *
Please enter your Lastname *
Mother's Maiden Name (Surname before marriage) *
Birth Last Name*Enter your last name as it was when you were born.
Country of Birth*
Place of Birth*Enter the town, city, county or region in which you were born.
Date of birth *Day12345678910111213141516171819202122232425262728293031MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear20022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950
Address line 1*
Address line 2
Post Code *
How long have you lived at this address?* Years Months
Passport numberPlease enter your UK passport number below. You will be giving your consent to access your personal data (including your photo and signature) held by the Identity and Passport Service (IPS). The information returned from IPS will be used to check your identity.
National Insurance numberBy providing your national insurance number, you are allowing it to be used by the DVLA to verify your identity. This is not mandatory, however, if you do not provide your national insurance number, it may delay your application and you may be required to verify your identity to the DVLA via post..
Confirm Details * I have read and agree to the Terms and Conditions and would like to proceed my application with Licence Services.
Please check the amount below and proceed to payment *First Provisional Licence £114