|S&B's Summer Session A will begin on Monday, May 18 and Summer Session B will begin
on Monday, June 1. Session A parent meeting will be on Wednesday, May 13 at 6:30 p.m.
and Session B will be on Sunday, May 31 at 6:00 pm. The driving portion of both sessions
may be completed throughout the months of May, June and July. Please call 576-SAFE or
e-mail us at firstname.lastname@example.org 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 - $425.00
(Includes driver test waiver)
Summer Session "A" 2015 - May, June and July
Summer Session "B" 2015 - May, June and July
Fall Session 2015 - August, September and October