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Participant Registration Form

To register your interest in participating in a simulator trial please enter the details requested below:

(A) Personal Details

Title
Home Telephone*
First Name
Work Telephone*
Surname
Mobile*
Address
E-mail Address
  Date of Birth (dd/mm/yyyy)
Town
Occupation
County
 
Postcode
   
* At least one contact phone number must be provided.

(B) Health

Height*
Weight*
* Optional

Do you have any problems with any of the following?

Blood Pressure

Eyesight

Hearing Problems
Travel Sickness
Other Health Problems

(C) Availability

When are you most likely to be available for trials? (Please tick all that apply)


Please add any additional comments below:


(D) Driving

Year Driving Test Passed
 (yyyy)
Other Driving Qualifications
(Please tick all that apply)

 
Average annual mileage in a car


 Type of vehicle(s) driven:
(Please tick all that apply)



(E) Current Vehicle

If you currently own a vehicle please fill in the following section otherwise please leave it blank.

Make
Model
Gearbox
Vehicle Use
(Please tick all that apply)


(F) Other

How did you hear about TRL's trials?

Personal information provided to TRL will only be used for contact purposes.

If you have concerns about the way TRL are using your personal information, contact the Data Protection Manager in writing at TRL, Crowthorne House, Nine Mile Ride, Wokingham, Berks, RG40 3GA.



The Data Protection Act 1998 gives you the right of access to your personal information held by TRL. An administrative charge of £10 (0% VAT) may be charged for such requests, and you will receive a response within 40 calendar days. Requests of this nature must be in writing, and you will be required to provide verification of your identity to authorise release of your information.