|S&B's Summer Sessions A & B will begin on Monday, May 19th or Wednesday, June 4th
with parent meetings on Wednesday, May 14 at 6:30 p.m. or Sunday, June 1 at 6:00 p.m.
The driving portion of the Summer Sessions may be completed throughout the months of
May, June or July. Please call 576-SAFE or e-mail us at email@example.com for
late registration or questions.
Student Name______________________________ Date of Birth_____/_____/_____
(As it appears on Birth Certificate)
Address___________________________________ Home Phone_________________
_________________________________________ Cell Phone___________________
Emergency Contact_________________________ Emergency Phone_____________
Name of Nearest Relative___________________________________________________
Driving Group - Please list the names of 1 to 2 students who you would like to drive with during
your behind the wheel training. If you do not have a preference, leave this section blank and
you will be assigned a group randomly.
1) _________________________________ 2) ________________________________
Amount Paid ___________________ Amount Due ___________________
|S & B Driving School Registration Form
Please print and mail to 7484 Christina Drive, Suite 102 West Harrison, IN 47060 prior to the
parent meeting. You may call 576-SAFE if you need to rush register.
Sessions (circle one) Session Fee due at enrollment - $420.00
Summer Sessions - May, June and July
Fall Session - August, September and October
Winter Session - November, December and January