2024 Driver Education Registration

STUDENT INFORMATION - please make sure it is their LEGAL INFORMATION and matches what is on their BIRTH CERTIFICATE.

FIRST NAME *

MIDDLE NAME *

LAST NAME *

DATE OF BIRTH *

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DD

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YYYY

AGE AS OF 1/1/24*

HOME ADDRESS *

PARENT EMAIL ADDRESS *

PARENT PHONE NUMBER*

STUDENT EMAIL ADDRESS *

STUDENT PHONE NUMBER *

PLEASE CHECK WHICH COURSES YOU WOULD LIKE YOUR SON/DAUGHTER ENROLLED. *

2024 Classroom Sessions

2024 Behind the Wheel

Check Here if your son/daughter will be getting their FARM PERMIT

PARENT INFORMATION: Please list parent name(s) *

CONCERNS: please list any concerns you have regarding scheduling for classroom sessions.

CONCERNS: please list any concerns you have regarding your son/daughter's enrollment in special education as it pertains to testing, reading, etc. This will assist me in working with their special education teacher to achieve optimal success in class.

CONCERNS: please list any concerns you have regarding your son/daughter's scheduling conflicts for spring/summer Behind the Wheel.

Important Information - If you register your son/daughter you are agreeing to the following
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1. That the fees must be paid to the office before a student will receive their documentation of course completion.

2. I understand that the students will be removed from class for poor behavior. Parents will be contacted upon removal and students may be required to re-take the entire schedule of class sessions at the next available date.

3. A "blue card" for completion will not be issued until a student has paid their classroom sessions at the next available date.

5. NO REFUNDS will be given after the start of classroom or BTW sessions. Students will be allowed to take the course at a later scheduled time within a 12 month period.

6. I understand that my son/daughter is allowed to bring their personal cell phone with to classroom or BTW sessions HOWEVER - they must turn them OFF during these times unless allowed by the instructor to use them for assignment purposes or emergencies. If you should need to contact your son/daughter during these times, please use the instructors number (218) 469-1375.