Hiree (Designated Driver) *

First Name

Last Name

Hire Dates (Collection) *

MM

DD

YYYY

Hire Dates (Return) *

Return

MM

DD

YYYY

I am hiring a: *

Land Rover Defender

Vintage VW

Land Rover Discovery

Have you held a full UK / EU / USA / Canadian / Australian / New Zealand driving licence for a minimum of 24 months? *

Yes

No

Are you aged between 23-75 years? *

Yes

No

Do you have LESS THAN 6 points on your licence? *

Yes

No

Were these points issued for minor offences? *

Yes

No

Not Applicable

Do you have any driving convictions that resulted in more than three points being issued? *

Yes

No

Have you had more than one fault or non-fault claim within the previous 5 years? *

Yes

No

I understand a £250 refundable security deposit will be paid before collection of the vehicle. This is an insurance requirement.

Yes

No