Is this a Renewal Application?
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Yes
Yes, but I am applying for a higher license designation
No, I am a new applicant
License Type
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License Upgrade
Lapping Only
Dutchway Only
Road Racing Novice
Road Racing Senior
Are you an Area 27 Member?
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Yes
No
Area 27 Membership Number (Members Only)
Name - First
Name - Middle
Name - Last
Contact Number
Emergency Contact
Emergency Contact Phone
Driver's License Number
Province
Performance Driving Experience
Performance Driving School or Accreditation
Upload your logbook files here
Add JPG, PNG, PDF, DOC, or DOCX logbook files. You may add up to 10 files across both upload areas with a combined size of 10 MB or less. Logbook files are securely attached to the staff copy of your application.
How this section works: complete the online questions below. Download the physician package, have your doctor complete and sign it, keep your copy, and upload the current signed package with this application. The age-based schedule below determines when a new physician examination is required.
Self-Declaration Status
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I am completing the online self-declaration below
I am not sure what is required
Physician Package Status
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Completed, signed and uploaded with this application
Completed and ready to upload
Appointment scheduled with my physician
I need to book the physician examination
Supporting Documents and Signed Physician Package
Upload your current doctor-signed physician package with each annual application or renewal, and keep your own copy. Obtain a newly completed package only when the age-based medical schedule requires it. You may also add licenses, accreditation, or experience documents. You may add up to 10 JPG, PNG, PDF, DOC, or DOCX files across both upload areas with a combined size of 10 MB or less. The selected files are securely attached to the staff copy of your application.
ORRA 27 medical-validity note from the application: applicants aged 50 and under must submit a physician-completed medical every 5 years; applicants aged 51 to 65 must submit one every 2 years; applicants aged 66 and older must submit one every year. Upload your retained current signed package with each annual application or renewal.
Frequent or severe headaches
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Yes
No
Unconsciousness for any reason
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Yes
No
Dizziness or fainting spells
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Yes
No
Epilepsy or Seizures
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Yes
No
Psychiatric / Mental Health Problems
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Yes
No
Allergies
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Yes
No
Eye trouble (except for glasses)
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Yes
No
Asthma
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Yes
No
Diabetes
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Yes
No
Anemia, or other blood diseases including abnormal bleeding
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Yes
No
Admission to a hospital in the last 12 months
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Yes
No
Amputations and or physical disability
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Yes
No
Previous denial(s) due to medical reason(s)
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Yes
No
Tetanus shot
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Yes
No
Coronary Artery disease or Angina
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Yes
No
Valve disease
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Yes
No
Abnormal Cardiac Rhythms
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Yes
No
High Blood Pressure
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Yes
No
Operation(s) involving Eyes, Brain, Heart, Nerves, Blood Vessels, or Bones
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Yes
No
Other Heart Issues
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Yes
No
Other Heart Issues
Applicant's Signature
Clear Signature
Draw with a mouse, trackpad, or finger.
Signature of Parent/Guardian (if under 18 years old)
Clear Signature
Required only for applicants under 18.
Please be advised that the submission and payment of an application does not guarantee the issuance of a license. Applicants must meet all applicable qualifications in order to be granted a license. If an applicant does not meet the required criteria for their desired license, the application will be declined, and any fees paid will be refunded.
If approved, the applicant will be invoiced directly for the applicable licence fee, which must be paid before the licence is issued. Do not enter credit-card details in this form.
Complete the secure verification before sending.
Submit License Application A valid email address is the only field needed to send the form. Blank fields, unsigned sections, and missing documents will not block submission; Area 27 staff can follow up. Need the doctor form first? Download the physician package , have it signed, retain your copy, and upload the current copy above.
