|S&B's Winter Session will begin on Sunday, January 19th with a parent meeting on Sunday,
January 12th at 6:00 p.m. The driving portion of the Winter Session may be completed
throughout the months of January, February and March. 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 - $400.00
Drive Test Waiver- $20.00
Winter Session 2014 - January and February
Spring Session 2014 - March, April and May