Registration for New drivers form

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New Drivers form

Course

First Name

Other Name

Last Name

Preferred Username

Password

Phone/Mobile

Email

Mother’s Maiden Name

Gender

Male

Female

Date of Birth

License Type

Blood Group

Facial Mark

Glasses

Height

Disabilities

Next of Kin Phone Number

Country (of Origin)

State of Origin

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Address

Address Line 1

City

State of Residence