Is this a Renewal Application?
Select one
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
Name - First
Name - Middle
Name - Last
Email Address
Contact Number
Emergency Contact
Emergency Contact Phone
Driver's License Number
Province
Expiry
Performance Driving Experience
Performance Driving School or Accreditation
Accreditation and Experience Uploads
Accepted file types on the ORRA form include jpg, png, pdf, docx, and doc. Shopify contact forms do not securely attach files, so Area 27 can request the actual documents after intake.
Logbook
How this section works: complete the questions below first. If ORRA 27 needs a signed PDF copy or a physician-completed medical, Area 27 will confirm that during the review.
Self-Declaration Status
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I am completing the online self-declaration below
I have also completed the printable ORRA 27 self-declaration package
I need the printable ORRA 27 self-declaration package
I am not sure what is required
Physician Package Status
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Not required based on my age/current medical status
Completed and ready if ORRA 27 requests it
I need to book the physician examination
I am not sure if this applies to me
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.
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
Date of Tetanus Vaccination
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
Select one
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.
Date
Signature of Parent/Guardian (if under 18 years old)
Clear Signature
Required only for applicants under 18.
Date
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.
