RSA DTT Application Form 2013:RSA Application Form 15/01/2013 14:56 Page 1

Application for a Driver Theory Test

Car (B), Motorcycle (A, A2, A1), Moped (AM), Tractor/Work Vehicle (W), Truck (including Step 1 of Driver CPC)
(C), Bus (including Step 1 of the Driver CPC) (D), Truck & Bus (including Step 1 of Driver CPC) (CD), Bus Module
(BMT) or Truck Module (TMT)

You can now book online at www.theorytest.ie

Application
Applicationfor
foraaDriver
Driver Theory
CPC Bus Test
or Truck
The fee for category AM, BW, BMT & TMT is €45; for category C & D is €72 and for CD is €84
Please Note: A separate
form is required for

Theory Test
TO BOOK PHONE 1890
Car (B)/Motorcycle (A,606 106 (Lo–call
A1)/Moped rate) Lín Áirithinte
(AM),(Certificate
Our operators are available from Monday
Tractor/Work Vehicle
to Friday 8.00am
trí Truck
(W), Ghaeilge
of Professional (C) or 1890
Bus (D)606
to 6:00pm to Competence
8066.
– Note
book your test and– Note 1)
immediately
CPC Case Study –Step 2
Applications.
confirm your appointment. Please have your Credit/Debit card, PPSN and PSC Card to hand.
YouYou
cancan
nownow
book online
book at www.theorytest.ie
online at www.theorytest.ieform
Please Note: A separate
is required for CPC
The fee forfee
The a Category AM,
for a Please
Driver BW,
CPC
read C sides
Bus
both oror
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Truck Test
andiscomplete
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this form 45.00
Test isthe144.00. (PartCAPITALS
form in BLOCK 1: 72.00 Part 2: 72.00)
Applications.
The fee for both a Bus & Truck combined Test is 216.00.
TOPersonal public service
BOOK PHONE number
1890 606 106
To (PPS
Book Number)
(Lo-call
PHONERate)
1890Text
606Phone 1890 616
106 (Lo-call 216
Driver
Rate) Líne Áirithinte
number
or TEXT (in BLACK trí
PHONE 1890 Ghaeilge
PRINT
616 216 1890 or606
on paper licence 806
4d on card)
Our operators are available from Monday nóto Friday 8.00am to 6.00pm to book your test
Líne Áirithinte trí Ghaeilge 1890 606 806 and immediately confirm your
Our operators are available from Monday
appointment. Pleasetohave
Friday 8.00am
your CredittoCard
6.00pm to book
and PPSN to your
hand.test and immediately confirm your
MANDATORY
appointment. MANDATORY
Please have your Credit/Debit Card, PPSN, Learner Permit FORLicence
or Driving C, D, CD,toBMT & TMT
hand. (Note 5)
PleasePlease
read both sides sides
read both of this
ofform and complete
this form the form
and complete in BLOCK
the form CAPITALS
in BLOCK CAPITALS
CATEGORY OF TEST CATEGORY BW
Personal public service number Cars, Driver
Driver number
number
No.)Tractors and Work Vehicles
(in PRINT
(in BLACK BLACK–PRINT–item
9 numbers 5– on
on your
your Learner
licence)Permit)
(TICK ONE ONLY)
Personal public service number (PPS
CATEGORY AM CATEGORY CD CATEGORY D
Motorcycles & Mopeds Truck & Bus Theory Test Bus Theory Test
MANDATORY
MANDATORY MANDATORY FOR CATEGORY C & D APPLICATION
CATEGORY C CATEGORY BMT Stock number (in REDCATEGORY TMT
PRINT–1 Letter + 7 numerals–on your Learner Permit)
Truck Theory Test CATEGORY OF TEST (TICK ONE ONLY)
MANDATORY Bus Module Test Truck Module Test
CATEGORY AM CATEGORY BW
Please tick if you would like to listen to the test through Irish English Polish Russian Lithuanian Arabic
CA TEGOR Y IrishOF
headphones in one Motorcycleslanguages.
of the following
TEST
& MopedsCars, Work Vehicles Tick) & Land Tractors
/ English / Polish (All categories) (PleaseRussian
Note: This option will not be available on the day of /*Multiple
Lithuanian Choice Questions
Arabic(MCQ)
(Category
testing unless selected in advanceCATEGORY C (Note 9) (Category
CATEGORYBWD Only) AM/BW only)
(*MCQ) (Part 1) €72 (*MCQ) (Part 1) €72 BUS & TRUCK (*MCQ) (Part 1) €72
BUS Trucks TRUCK Buses
YOUR DETAILS Bus Case Studies (Part 2) €72 Truck Case Studies (Part 2) €72 Bus & Truck Case Studies (Parts 2 combined) €144
PLEASE NOTE – Your First Name(s) and Surname(s) Must match exactly the name and surname on the form of Identification that will be presented at the test
Center. Please note the date that you NOTE
PLEASE post your application. If after 14application.
days
youryou have NOT received an appointmentNOT confirmation, please contact 1890 606 106
YOUR DETAILS
YOUR DETAILS
IMMEDIATELY. Failure to do so could
PLEASE
result
contact 1890
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contact
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If after youdays
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appointment
fee or missed
confirmation,
an appointment
(Note 2).(Note 3)
appointment.
please
confirmation, please

Title Ms/Miss/Mrs/Mr First Names

Title Ms/Miss/Mrs/Mr
Ms/Miss/Mrs/Mr Names
First Names Surname
Surname
Surname Gender
Gender M/F M/F
Gender
M/F

Address
Address Date Date
of Birth Bi Day
of Birth DayMonth Month
Year Year

Country of Birth
Daytime Tel. No. Bi Bi
County County Daytime Tel. No.
IF PROVIDED,
IF PROVIDED,CONFIRMATION WILL
CONFIRMATION WILL BE BYBE BY EMAIL
EMAIL
MobileMobile
ONLY ONLY
Tel. No. Bi Bi
Tel. No.
Country
Country EmailEmail
CONFIRMATION
TELEPHONE CONFIRMATION
TEXT NUMBER
PROVIDED
IS24 TEXT
HOURS
MANDATORY PROVIDED
PRIOR TO TEST DATE

Where Where
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Please
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10 days
allow 10
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for postal
days for postal
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postal application.(Note
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Day Month
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If the
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www.theorytest.ie at www.theorytest.ie
at www.theorytest.ie
or alternatively by or alternatively
or telephone
alternatively bythe
using by telephone
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number using
at using
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the top theform.
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at the at
topthe
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form.
Do you If youahave
have a special
special need
need or or disability
disability thatrequire
that may may require special
special arrangements
arrangements to your
to take take your test dyslexia,
test e.g. e.g. dyslexia,
otherorreading,
other reading
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Do you have a special need or additional
disability that may requirebespecial arrangements to taketime.
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difficulties etc.? Note support
9 Please note can
if you provided,
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send
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medical
medical difficulties
evidence
evidence from
from aorschool,
a hearing
school,
issues? PLEASE NOTE - If you require additional support, you will need to provide medical evidence from a school, doctor or employer on headed paper
doctor
doctor orwith or
employer employer
on headedon headed
paper paper together with this completed application form. Upon receipt we will contact you to make
together this application form. Upontogether with
receipt we willthis completed
contact application
you to make form. Upon
the arrangements for receipt we will contact you to make the
your test.
the arrangements
arrangements
See
or for
or for further
note 10 for Language
further
information
Support
information you may Email theorytesthelp@prometric.com
Services. you may Email theorytesthelp@prometric.com (Please(Please
(PleaseTick)
Tick) Tick)

Please tick if you tick

Please would if like
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listen tolike
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testlisten to the
Irishtest (Note English Polish English
Russian Lithuanian
CREDIT/DEBIT
through through
headphones CARD
in one ofDETAILS
headphones the in
following
one oflanguages.
8)
the following languages.
Irish Please charge to my
Irish / English / Polish (All categories) (Note 9)(Category
Russian / Lithuanian BW ONLY)
I wish to pay by Mastercard/Visa. Please charge my account. My card number is: Expiry Date account
CREDIT/DEBIT CARD DETAILS
CREDIT/DEBIT
I wish to CARD DETAILS
pay by Mastercard/Visa. Please charge my account. My card number is: €
I wish
Remember, with to pay Card
a Credit by Mastercard/Visa. Please
or Voucher you can book onlinecharge my account.
immediately My card
at www.theorytest.ie number is:

Title Date
Expiry Name Please
of card charge
holder to my account Signature of card holder Date
Expiry Date Please charge to my account Remember, with a Credit CardDay
or Voucher you canYear
€ Month
book online immediately
€ Remember, withatawww.theorytest.ie
Credit Card you can book
PAYZONE
Title VOUCHER
Name of card holder Signature of card holder
online immediately at www. theorytest.ie
Date
Voucher Number Expiry Date Day Month Year
DETAILS (Note 6)
Title Name of card holder Signature of card holder Day
Date
Month Year
Day Month Year
PAYZONE VOUCHER Voucher Number Expiry Date Day Month Year
DETAILS (Note 6)
You can now book online at www.theorytest.ie
1. Driver Theory Test Centres
Test may be taken at the following centres:

Abbeyfeale Cork Galway Nenagh

Athlone Derrybeg Kilkenny Portlaoise
Ballina Donegal Killarney Skibbereen
Cahirciveen Drogheda Letterkenny Sligo
Carlow Dublin IFSC Limerick Tralee
Carrick-on-Shannon Dublin North Longford Tullamore
Castlerea Dublin South (Dun Macroom Waterford
Cavan Laoghaire) Monaghan Westport
Charleville Dublin West Mullingar Wexford
Clifden Dundalk Naas Wicklow
Clonmel Ennis Navan Youghal

2. Make a note of the date you post your application and if after 14 days you have not received an appointment
notification, please contact 1890 606 106 (Lo–call rate) immediately. If you don’t, you may miss your appointment and
lose your fee.
3. Web Bookings: www.theorytest.ie
4. Phone Bookings: Call 1890 606 106 (Lo–call rate) and have your PPS number and Credit/Debit Card details or Payzone
Voucher to hand and Driving Licence if you have one. If you are not the card holder, the card holder must be present to
authorise the use of the card.
5. Fax Bookings: Fax this completed application to 042 9368899.
6. Postal Bookings: Send this completed application form with your postal order or cheque to the following address: Driver
Theory Test, PO Box 15, Dundalk, Co. Louth. Postal orders and cheques must be made payable to Driver Theory Test.
Payment note – in addition to paying with a Credit/Debit Card, postal order or cheque you may also pay for your AM &
BW test with a voucher obtainable from any outlet displaying the Payzone Sign.
7. Required Documents: When you arrive to take the Driver Theory Test, you will need to have a valid Form of ID.
a. A full list of acceptable I.D. are listed in our website www.theorytest.ie and the email/letter confirmation you
will receive. Only valid ( in date) and original documents in good condition will be accepted. The name(s) and surname(s)
must match exactly with the details on this application form or you will not be able to test and will lose your fee.
Please note: For a category C, D or CD theory test you must present a valid, full Irish category B, C or D driving licence
(or one from another EU/EEA member state or Switzerland). For a Truck Module Theory test you must also
present a current category D learner permit or full Irish category D driving licence or one from another EU/EEA member
state or Switzerland. For a Bus Module Theory test you must present a current category C learner permit or full Irish
category C driving licence (or one from another EU/EEA member state or Switzerland).
8. Certification: This form covers applications for Driver Theory Test Categories AM, BW, C, D and CD, which once passed
will allow you to obtain a Learner Permit in these categories. Categories C, D and CD also provide candidates with the
first step of the Certificate of Profession Competence (CPC).
The form also covers the applications for the Bus or Truck Module Theory Tests for drivers who have already passed the
full Bus or Truck Theory Test. For example, when a driver sits and passes the full Bus Theory Test, this provides them with
a Driver Theory Test Certificate in driving a bus, plus the first step of the Certificate of Professional Competence (CPC).
If within two years of passing the full Bus Theory Test the candidate decides they would like to drive a truck also, they
can sit the Truck Module Theory Test, meaning that they do not need to sit the full Truck Theory Test. However, if you
have not passed this module theory test within two years, you will then be required to sit the full Truck Theory Test.
9. Irish Language: An Irish language version of this form is available. If you complete a form in Irish, an Irish language
version of the Theory Test will be provided on the day of your test.
10. Language Support Services: Translator support tests are available by special arrangement at the following test centes;
Dublin Central, Dublin North (Santry), Sligo, Waterford, Cork, Galway, Limerick. This support is for candidates who do not
speak or understand English. Evidence of a candidate’s requirement of this service must be provided. For further
information please email; drivertheorytest@prometric.com or call the booking line on 1890 606 106 (lo-call rate).
11. Cancellation/Reschedules: If you wish to cancel or reschedule your Theory Test appointment, you must give us at least
5 working days notice or you will lose your fee. For example, to reschedule or cancel a test booked for a Friday you must
let us know on the previous Monday.
12. Test preparation: The test questions are taken from the question bank in The Official Driver Theory Test Questions
and Answers, Cars, Motorcycles and Work Vehicles June 2017 Edition book or CD-ROM and The Official Driver Theory
Test Questions and Answers, Truck and Buses June 2017 Edition book or CD-ROM. We have now launched an online
learning portal please see dttsore.promtric.com for more details!