| The Fall Session will begin on Tuesday, September 7th. The driving portion of the Fall Session may be completed throughout the months of September and October. Please call 576-SAFE or e-mail us at drive@sbdrivingschool.com for late registration or questions. |
Student Name______________________________ Date of Birth_____/_____/_____
(As it appears on Birth Certificate)
Parent/Guardian__________________________________________________________
Address___________________________________ Home Phone_________________
_________________________________________ Cell Phone___________________
_________________________________________ Email_______________________
Emergency Contact_________________________ Emergency Phone_____________
Name of Nearest Relative___________________________________________________
Medical Conditions________________________________________________________
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 ___________________
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| 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 - $425.00 Fall Session 2010 - September 17 - October 17 Late Fall / Winter 2010 - November & December - TBA Winter 2011 - January & February - TBA |