EVALUATION FORM – LICENSED DRIVER
Driver Name & Surname
Driver Name & Surname
First
First
Surname
Surname
Enter driver company
Driver Identification selection
South African ID
Foreign ID
Enter foreign ID number
Enter South African ID Number
Licence Code
Licence Expiry Date
PRDP Expiry Date
Enter date of Assessment
Enter time of Assessment
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Facilitator Name & Surname
Facilitator Name & Surname
First
First
Surname
Surname
Class of vehicle
*
Sedan
LDV/SUV
Minibus <16 Ton
Minibus >16 Ton
Truck/Bus
Rigid
Articulate
Vehicle Manual/Auto
Manual
Auto
Time of day
Day
Night
Visibility
Good
Fair
Poor
Road Conditions
Wet
Dry
Road Surface
Tar
Gravel
If you are human, leave this field blank.
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