ADI Payment Request

Customer name*
First Last
Customer post code*
P number*
Course duration*
Transmission*
Driving test date*
DD slash MM slash YYYY
Driving test reference number*
ADI name*
First Last
ADI number*
Is ADI registered with us*
ADI payment date*
MM slash DD slash YYYY
Course start date*
MM slash DD slash YYYY
Course start time*

: Hours

Minutes
Deposit amount*
Zone*
Has balance been received*
Balance amount*
Is this an upgraded fee*
Cost of difference*
Total to pay ADI*
ADI account number*
ADI sort code*
Name on the account*
First Last
What type of account*
Form submitted by*
Date form submited*
MM slash DD slash YYYY
Have you changed the DIS status*
Have you activated fast track*
Has the starter pack been prepared*
Has - pupil about to start text been sent*
Has Kashflow purchase invoice been raised & sent*