|S&B's Fall Session will begin on Wednesday, August 17th. The parent meeting will be held
on Sunday, August 14th 6:00 p.m. The driving portion of the Fall Session may be completed
throughout the months of August, September and October. Please call 576-SAFE or e-mail
us at firstname.lastname@example.org for late registration or questions. Thank you!
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 - $425.00
(Includes driver test waiver)
Fall Session 2016 - August, September and October
Winter Session 2016/17 - November, December, January and February
Spring 2017 - March, April and May