ENROLL Drivers Ed Driving Only

6 Hours Driving - $495 / $250 Deposit Collected After Enrolling

NAME OF PARENT 1 *

HOW DID YOU HEAR ABOUT US?

WHERE DID STUDENT TAKE CLASSROOM PORTION OF DRIVERS ED?

DID STUDENT HAVE VISION TESTED BY THE CLASSROOM PROVIDER?

STUDENT ADDRESS *

NAME OF PARENT 2

PARENT 2 EMAIL ADDRESS

STUDENT'S SCHOOL

STUDENT PHONE NUMBER

ENROLLMENT FORM

6 Hours of Driving for

NC Learner's Permit

Tuition is $495. a $250 non-refundable deposit is due upon enrollment. The balance is due at the 1st lesson.

PARENT 1 EMAIL ADDRESS *

IF YOU ARE UNABLE TO SUBMIT THIS PAGE, PLEASE BE SURE YOU HAVE FILLED-IN ALL REQUIRED FIELDS. QUESTIONS / COMMENTS BELOW

STUDENT'S DATE OF BIRTH *

STUDENT'S EMAIL ADDRESS

CITY *

FULL NAME AS APPEARS ON BIRTH CERTIFICATE *

ZIP *

PARENT 1 PHONE NUMBER *

PARENT 2 PHONE NUMBER