|S&B's Summer Sessions will begin on Monday, May 16 (Session A) and Friday, May 27
(Session B). The parent meetings will be held on Sunday, May 15 (Session A) and May 22
(Session B) at 6:00 p.m. The driving portion of the Summer 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. 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)
Summer Session 2016 - May, June and July
Fall Session 2016 - August, September and October
Winter Session 2016/17 - November, December and January