free teen application | The Drivers License School

Name *

dob *

last 4 digits of social security number *

address/city and zip code *

student cell phone number *

parent cell phone number *

emergency contact name and cell phone number *

parents email *

By signing this you understand that your teen is required to complete 32hrs of classroom If student misses a day its 20dollars to make up each day missed. Make up days will be at the end of class. 75dollar fee to replace de964 if lost *

male or female *

Signature of Parent/Guardian (Younger than 18)* *

start date of classroom only classes *

All Cancellation/supply fees will apply 150dollars Please Sign that you are aware of this policyy *