2021 Central Springs Driver Education Registration
Complete this form in its entirety to be registered for driver's education.

Cost for the class is $310. Payment can be submitted to business manager Gwen Mellmann at either campus. If the student qualifies for free/reduced pricing, please contact Gwen Mellmann to determine your rate for 2021 drivers education.

A registration form must be completed by Wednesday, February 24th either electronically or by paper form. Paper forms can be submitted to Laura at the middle school office in Nora Springs or to Katie in the high school office in Manly.

Class is limited to 60 students. If more than 60 students sign-up, priority will be done by age and completion of registration & payment on or before the registration deadline of Wednesday, February 24th.

Mandatory Parent/Student meeting on Monday, March 1st from 5:00 - 6:00 PM at the Manly auditorium or via Zoom meeting (link to be provided after registration is completed).

This will be an all on-line course with mandatory Wednesday afternoon meetings to be held in the Manly auditorium or via Zoom from 4:00 - 5:00 PM. Drive times for students will be setup during this time and also check on student progress through the online modules.

*If the online version is not completed by Friday, May 28th an $30 extension will be charged

Any questions please contact:

Scott Dobel - Instructor
sdobel@centralsprings.net

Bill Shafer - Instructor
bshafer@centralsprings.net

Gwen Mellmann - Business Manager
gmellmann@centralsprings.net
Student Name *
Student Birthdate *
Student Grade Level at Central Springs for 2020-2021 School Year. *
Student Social Security Number *
Student Permit Number *
Student Permit Expiration Date *
Parent/Guardian Name *
Student Residence Address *
Mailing Address *
Parent/Guardian Phone Number *
Parent Email Address *
Student Phone Number *
Student Email Address *
Parent/Guardian Electronic Signature. By typing your name below, you affirm that the above information entered is correct. *
Submit
Never submit passwords through Google Forms.
This form was created inside of centralsprings.net. Report Abuse