Student Driver Info
First Name of Driver *
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Last Name of Driver *
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Driver's License Number *
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Address *
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Phone Number *
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Guardian Names *
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Guardian Phone Number *
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Vehicle #1 Make (ex. Chevrolet) *
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Vehicle #1 Model (ex. Malibu) *
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Vehicle #1 Year *
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Vehicle #1 Color *
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Vehicle #1 License Plate # *
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Vehicle #2 Make and Model
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Vehicle #2 Year
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Vehicle #2 color
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Vehicle #2 License Plate #
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I hold a valid driver’s license and it is not currently suspended or revoked. I know that driving to and from school is a privilege and to maintain the privilege I must drive in a safe and courteous manner. I understand that, if applicable, I will obey restrictions of 16 & 17 year olds who hold a probationary driver’s license (including passenger restrictions). I must enter and depart the parking lot in an orderly manner. The speed limit on school property is 10 mph. Any violation of a school rule including, but not limited to, driving safety, attendance, excessive tardiness, or a violation of any stipulations in the agreement or the spirit of this agreement, or any behaviors determined to put health and/or safety at risk, may result in the loss of driving privileges. Some examples of situations/behaviors for which driving privileges may be revoked include, but are not limited to: receiving a moving violation or warnings while driving to or from school, violating driving laws, failure to secure seatbelt and having passengers do the same, inappropriate (age) use of electronics while driving (texting, cell phone calls, etc.), being reported as driving in an unsafe manner by a credible source (as determined by administration), exceeding passenger limits, engine revving, spinning/squealing tires, unnecessary horn blowing, transporting anyone in the back of a pick-up truck, participating in car surfing, inappropriate changing of clothes in/around cars. Students are not to loiter in their vehicle, another student’s vehicle, or the parking lot upon arrival, at dismissal, or during the day when coming/leaving for college classes. Student vehicles are subject to searches while on school property or at school functions. Refusal to allow access to my vehicle for a search is viewed as insubordination and may result in my suspension and/or expulsion from school. Police dogs may be used to detect illegal substances in student vehicles. I realize these rules encompass driving to or from school for class or any school function. By signing this form, I agree to the above terms and conditions of driving to school.Student
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