Driver's Education Registration Form
Dufrene Driving School
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Email *
Student's Name (First & Last Name) *
PLEASE DO NOT SUBMIT ONLINE REGISTRATION FORM IF YOU ARE NOT PAYING ONLINE WITH CARD/PAYPAL. CALL US AT 985-532-6390 IF YOU WOULD LIKE TO MAKE AN APPOINTMENT TO PAY WITH CASH OR CHECK. STUDENT'S INFORMATION WILL BE OBTAINED THEN.
Student's Date of Birth *
MM
/
DD
/
YYYY
Contact Number w/ Area Code *
Email Address *
PLEASE ENTER THE EMAIL ADDRESS WHERE YOU WANT THE CLASS INFORMATION SENT TO
Select a Class from Options Below *
38hr Classes are for students under the age of 18; 14hr Classes are for any student over the age of 18
Select Payment Amount *
ALL ONLINE PAYMENTS WILL INCLUDE A 4.4% SERVICE FEE. IF YOU PREFER TO PAY VIA CASH OR CHECK, PLEASE CALL 985-532-6390.
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