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Remote Class Enrollment Form
Remote Class Enrollment Form
Tammy
2023-03-15T15:30:50-05:00
Remote Class Enrollment
Student Information
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*
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*
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Remote Driver Education Class (32 hours Classroom & 7 two hour driving lessons.)
Other Services
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Remote Classroom Instruction Only (32 hours)
Total
Remote Class Enrollment
Start Date
*
MM slash DD slash YYYY
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*
:
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Select School Location
204 N. Greenville, 300 / Allen 75002 / 214.383.9795
6449 Coit Road, 113 / Frisco East 75035 / 46.-633.7110
4900 Eldorado Parkway, 132 / McKinney 75070 / 214.504-9292
4433 Punjab Way, Ste 401 / Frisco West 75033 / 214.705.9959
School may terminate Student’s enrollment if Student accumulates absences in excess of 5 days of scheduled classroom hours. Driver Permit may be revoked if classroom is not completed within two hundred ( 240) days.
The Parent and Student agree that all classroom and in-car lessons must be made-up/completed within the 240 days of the classroom beginning date.
Initials
*
I agree to the terms and Conditions
*
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No
Signature
*
Disclosure
Medical Condition
*
Does your student currently have or had ever been diagnosed with or treated for any medical condition that may affect his/her ability to safely operate a motor vehicle?
Yes
No
Hospitilization
*
Within the past two years, has your student been diagnosed with, been hospitalized for or currently being treated for a psychiatric disorder? Examples included but not limited to ADHD, ADD, epileptic seizure, convulsion, loss of consciousness or other seizure.
Yes
No
If Yes, please explain
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