Marine Licence Training booking form

Step 1 of 2: Submit

Please complete this booking form for boat licence training and assessment. L P Communication highly recommends that you 1.Study the Victorian Recreational Boating Safety Handbook 2. Try the practice tests for the marine licence/PWC endorsement These can be found at http://transportsafety.vic.gov.au/maritime-safety/recreational-vessel-operators/powerboat/licensing

Date of training you wish to attend

Location of Training Full name (as it appears on your primary ID proof document) Date of Birth

Current Address Postcode Drivers Licence of Learner permit No. Primary ID (only if you do not have a drivers licence or learners permit) Secondary ID (only required if you do not have a Drivers Licence or Learners Permit

Are you currently suspended or disqualified from holding a marine licence ? No Yes

Do you have any medical conditions that may affect your fitness to operate a recreational vessel? ref. https://www.vicroads.vic.gov.au/licences/medical-conditions-and-driving No Yes

Residential address if not the same as on your primary of secondary ID Contact Phone No Contact email address

Have you read L P Communications Marine licence Pre - Training information, located at www.lpcomm.com under the marine licence tab YES NO

Do you approve to be contacted by MSV for the purpose of obtaining feedback about training and assessment services provide to you. YES NO