This form will allow you to book a hire vehicle for either a disabled driver or passenger. For a complete listing of facts and information regarding our hire vehicle program, please click on this link. In order to accurately complete the booking form, we urge you to fully review the facts and information page. For example, we will need to know the head height of a wheelchair occupant so as to assign an appropriate wheelchair accessible vehicle.

After completing the booking form, a representative from Motability Ireland will contact you to verify the information. At that time our representative will also take your credit card details to reserve the vehicle. 

To be equitable for all our rental customers, Motability Ireland employs a cancellation policy. There is no charge if a customer cancels their rental 30 days in advance of the rental. Cancellations which fall from 29 to 15 days before the commencement of the rental may be charged up to 25% of the rental plus VAT of 13.5%. Cancellations less than 2 weeks before the rental begins may be charged up to 50% of the rental cost plus VAT of 13.5%. This policy is necessary because throughout the year, there are sometimes periods in which demand is greater that our supply of rental vehicles.

 

 

* = Required Fields

Registration Information
Email Address *
 
Surname *
 
First Name *
 
Middle Initial
Contact Details
Address *
 
Address 2
Address 3
City *
 
State/ County/ Province *
 
Post Code *
 
Country *
 
Day Phone Number *
 
Evening Phone Number
Mobile Phone Number
Driver Information
Date of Birth *
License Number *
 
License Issue Date *
License Expiry Date *
License Issuing Authority *
 
Insurance Information
The following information is necessary if you wish to or are required to purchase vehicle insurance from our carrier.
Occupation
Employer Name
Employer Address
Tick the below box if you have been convicted of any driving offences in the past 3 years or are there any pending prosecutions?
Driving Offense
Driving Offense Detail
Additional Drivers Available
Drivers that are currently associated with your profile.
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Click 'Next' to continue the booking process.