Learner Loaner Application Form

Completing this form does not guarantee that the NABD can provide a suitably adapted vehicle.
The NABD retain the right to refuse Learner Loaner Applications that do not satisfy our constitutional criteria.

Applications will be withdrawn if any of the information given in the application proves to be false.

Please Upload copies of both sides of your Driving Licence in jpeg, jpg or gif format of up to 100k in size using the fields below.
If you can not scan & upload your Licence at this time, please forward copies to the NABD, addressed to:
Learner Loaners
Unit 20, The Bridgewater Centre
Robson Avenue
M41 7TE
Post Code*
Date of Birth*
NABD Membership Number*
Email Address*
Telephone No - Home
Telephone No - Mobile
Nature of Disability*
Please label your scans as "Yourname_DL1_LL" and "Yourname_DL2_LL" so we can identify them accordingly.
File types accepted are jpg, jpeg and gif of a maximum 100k each in size.
The images will not be stored on the webserver once the form has been emailed to the Learner Loaner Officer.
Driving Licence 1
Driving Licence 2

Please confirm that you are not a script by entering the letters from the image.

Previous page: Learner Loaners Next page: Reps Log In