PRICE $270

TEEN BEHIND-THE-wHEEL REGISTRATION FORM

You must be between 15 yrs 6 mos - 17 years old to take behind-the-wheel course

Student Name*

Age and Birthdate*

Student Street Address, City & Zip Code*

Student Cell Phone & E-mail address:*

Parent Name & Cell Phone#*

Email*

Do you have a permit? (if yes how many months have you had it)*

HAVE YOU COMPLETED 45 HRS. OF ON ROAD DRIVING WITH PARENT?*

Have you completed 36 hours of classroom instruction?*

What School do you attend:*

Do you have early release from school everyday?

Approximate Start Date:*

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.

Decline Accept