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I am the parent or
legal guardian of the above applicant and I have the legal right
to give permission for him/her to take this course in driver
education. I hereby give my permission for my son or
daughter to participate in driver education at Drivers Edge
driving school. I have read and agree to the terms and
conditions of this application.
Student's
Signature: _____________________ Date: _________________
Parent's
Signature: _____________________ Date: __________________
You must attach
one (1) copy of the student's Birth Certificate to this
application and include the original certificate. The
original will be returned to you. Please also attach one
(1) copy of the student's social security card.
Invoice
Date: _________________________
Please
enclose check or money order $110.00 deposit or
fill out your credit information below to hold
space in class since space is limited for class
size.
To
Pay by Credit Card:
MasterCard Visa
Discover
Card
Number :
Signature:
___________________________ Expiration Date:
/
Amount
to be paid by credit card: $_________
To
pay by Check: Make payable to DRIVERS EDGE
Mail
to:
Drivers Edge
34
Lancaster Brook Road
Glenburn
,
ME
04401
Phone: 207-941-9494
Cell Phone: 207-745-7390
(Page
2 of 2 to be filled out and mailed)
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