Student Enrollment Agreement
MUST be completed by Parent or Legal Guardian. You are welcome to change classes and or courses after you complete the registration. Just come back here and complete a new registration. We can delete the prior one(s). We do not charge a deposit but ask that you let us know if you are not going to come to a class you have registered for. If you are doing Online Classroom and Behind the Wheel with us, you will need to return here and fill out this form again when it's time for you to enroll in our Behind The Wheel course.
Email address
What is the Student's Name, Last, First and Middle Initial
Last Name, First name, Middle Initial (ex. Jones, Fred, G)
Your answer
What is Student's birth date?
ex. 12/23/00
Your answer
What is Student's STREET ADDRESS?
ex. 123 Maple Ave
Your answer
What CITY do you live in?
Your answer
What is your ZIP CODE?
Your answer
What high school does student attend?
Your answer
Which course are you requesting?
Refer to our website for current fees for the location you are requesting.
Which class date and time is student requesting?
Class DATES and TIMES are subject to change. Choose the appropriate class from list below.
Where do you plan to do your Behind The Wheel?
Be advised, the fees charged at our various schools and partner schools varies. If doing an Online Classroom you will enroll in a Behind the Wheel course with your school of choice after you complete all 15 Online Sessions.
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