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Sunshine: Drink drive behaviour change program part 2
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Sunshine: Drink drive behaviour change program part 2
29/01/2020 @ 6:00 pm
9:00 pm
You must complete part 1 and part 2 of the program
Please Click Here to Register Now
Please Note: Payment only necessary for Part One (Cost covers both parts of the program)
Your Surname
*
Given Names
*
Email
*
Contact Phone
*
Date of Birth
*
DD
MM
YYYY
Drivers Licence Number
Your Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Date of the Offence
Date Format: DD slash MM slash YYYY
What was your BAC reading?
*
Please provide a description of any other charges made:
*
Number of related offences in the last 10 years
*
Date of prior offence (if applicable)?:
Date Format: DD slash MM slash YYYY
Is there anything else we should know about?
Payment Options
$300 + $67 Vic Roads Fee (Without a Health Care card)
$300 + $34 Vic Roads Fee (With a Health Care card)
For credit card payments please contact us
on 9654 3321.
Please note, the $67 and $34 fees are VicRoads fees and not ours and are required to be paid prior to commencement of the program.
Health Care Card Number
Health Care Card Expiry
Date Format: DD slash MM slash YYYY
Non-refundable $100 deposit required.
Please contact us to organise a $100 deposit. Deposit must be paid minimum 5 days prior to commencing the program. If deposit is not paid, you are not booked in.
For advance payments, your payment must be made
minimum
2 days prior to the program date.
Name
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Details
Date:
29/01/2020
Time:
6:00 pm9:00 pm
Event Categories:
drink drive programs/assessments
,
Sunshine Uniting Care
Website:
drinkdriveassist.com.au
Organiser
Awareness Driver Education
Phone:
03 9654 3321
Email:
awarenes@hotkey.net.au
Website:
drinkdriveassisst.com.au
Venue
Sunshine, Sunshine Uniting Care
32 Withers St
Sunshine
,
VIC
3020
Australia
+ Google Map
Phone:
9654 3321
+ Google Calendar
+ iCal Export
Details
Date:
29/01/2020
Time:
6:00 pm9:00 pm
Event Categories:
drink drive programs/assessments
,
Sunshine Uniting Care
Website:
drinkdriveassist.com.au
Organiser
Awareness Driver Education
Phone:
03 9654 3321
Email:
awarenes@hotkey.net.au
Website:
drinkdriveassisst.com.au
Venue
Sunshine, Sunshine Uniting Care
32 Withers St
Sunshine
,
VIC
3020
Australia
+ Google Map
Phone:
9654 3321
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