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Introduction: Rent A Scooter |
Rental Package Ł99 |
Rental Package Ł149 |
Rental Apply Online

Rental Apply Online 2010

Please complete all the fields and submit the form below.

About You

Title:
First Name:
Last Name:
Previous Name:
Email:
Day Time Phone:
Date of Birth:

Marital Status:

Licence Type

Full: Provisional:

Your Address

Residential Status: Are you a?

Home Owner Tennant Living With Parents

Address 1

Address:
Address:
Town:
County:
Postcode:

Time at this address

Address 2

Address:
Address:
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County:
Postcode:

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Address 3

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Address 4

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Address 5

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Address 6

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Address 7

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Address 8

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Address 9

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Address 10

Address:
Address:
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Your Occupation

Part Time: Full Time:

Occupation:

Employed: Self Employed: Education:

Employment Details

Employers Name:
Employers Phone:
Address:
Address 2:
Town:
County:
Postcode:

Time with this employer

Your Bank Details

Bank Name:
Bank Account Number:
Bank Sort Code:

Further Information

Will you be using the bike / scooter to travel to and from work/school?

YesNo

Do you have any convictions to disclose?

YesNo

Conviction Type:
Conviction Date:

Fine Amount:
No of Points:
Banned:

YesNo

Do you have any accidents or claims to disclose?

YesNo

Accident / Claim Date:

Claim Type:

Was the accident your fault?

FaultNon Fault

Claim Amount:

Claim Description:

Where is the vehicle kept at night?

DAS module 2 pass rate 90% for May 2010

Consider Get Bike's unique long term rental packages that includes

Brand new Scooter
Approved Training
Helmet
Jacket
Gloves
Wet proof trousers
Reflector vest
Third party fire & theft insurance
Breakdown cover

Warranty and regular servicing for Ł99 per month!

From only £99!
All training packages include full damage cover so there is no need for any additional insurance. This means if you drop or damage the bike you use, then you are not liable for any excess.

Asymmetry Contact us at Get Bike in West London: call 020 8326 3366 or email: