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PECHS Driver Ed Registration Form
Please complete form in order to sign your student up for the upcoming Dr Ed class . Note that you will be required to attend a Parent Meeting where you will gather information about class schedule. During the Parent meeting you will be required to pay PCS $65.00 (cash, cashier check or money order ONLY) You will also need to bring your students birth Certificate to Parent meeting. Your student MUST be 14.5 years old by the first day of class in order to take the class. Please do not register if your student is not old enough to take the class. Parent Meeting will be held at PECHS April 9th at 6 pm. Meeting will be after first day of class.
Email address *
Class Start date for PECHS *
Student MUST be 14.5 before the first day of class! DO NOT register if your student does not meet this requirement as they will not be able to take the class. Class will begin April 9th, 2018. Class will be held every Monday, Wednesday and Thursday from 3:30 to 6:30. Class will end April 30th. Students must attend all scheduled class dates.
Student Last Name *
Your answer
Student Middle Name *
Your answer
Student First name *
Your answer
Students Date of birth *
MM
/
DD
/
YYYY
Student Phone number *
Your answer
School *
List the school you are currently enrolled in
Required
Current grade *
List the grade you are currently in. If this is a summer class list the grade you are going in to
Required
Parent / Guardian First and Last name *
Your answer
Parent / Guardian Phone number *
Your answer
A copy of your responses will be emailed to the address you provided.
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