Smart Start Canada – Formulaire d’installation pour les clients du Ontario

S’il vous plaît permettre à 2 jours ouvrables pour recevoir votre réponse.

Please ensure that all of the below information is accurate. Information that is incomplete, or not accurate, will cause delays in the processing of your appointment.

Program Information

What Category Do You Fall Under?*
- MTO Program Stream A, B, C or D
- Voluntary Program
- Probation Order
*Stream A, B or D Clients: Please make sure to complete any Back On Track requirements and/or pay the necessary Reinstatement fees to avoid booking delays.

Personal Information

First Name (required)*
Middle Name
Last Name (required)*
Date of Birth (required)*
YYYY dash MM dash DD
Cell Phone Number (required)*
Home Phone Number
Email Address (required)*
Driver's License Number (required)*

Address

Street Address (required)*
City/Town (required)*
Hidden
Province
Hidden
Country
Postal Code (required)*

Additional Info

Next of Kin (Name - Relation)
Next of Kin Phone Number

Installation

Preferred Installation Date
Please provide a minimum of 2 days from the current date. Please do not request Saturday or Sunday, the appointment may not be honored.
YYYY dash MM dash DD
- Morning
- Afternoon
Secondary Installation Date
Please provide a minimum of 3 days from the current date. Please do not request Saturday or Sunday, the appointment may not be honored.
YYYY dash MM dash DD
- Morning
- Afternoon

Vehicle Information

Vehicle Year (required)*
Vehicle Make (required)*
Vehicle Model (required)*
Vehicle Start Type (required)*
Vehicle Colour (required)*
Vehicle Identification Number [VIN] (required)*
License Plate Number (required)*

Additional Notes
This can be used for additional details, e.g., you are hearing impaired and require a light-indicator for device notifications in the car, etc.
Name
Ce champ n’est utilisé qu’à des fins de validation et devrait rester inchangé.

Smart Start ne partagera les informations avec le client que si ce dernier a moins de 18 ans. Aucune information ne sera transmise à la famille proche ou à une tierce partie. Dans le cas où un mineur aurait besoin d’un verrouillage, la signature d’un tuteur serait alors requise. De plus, un tuteur doit être présent lors de l’installation et du retrait du dispositif de verrouillage pour les personnes de moins de 18 ans.

Contactez-nous aujourd’hui

Province de Québec: (844) 282-8300

Ouest / Centre du Canada: (844) 432-4776