Drivers Edge Registration Form

 

 

DRIVERS EDGE
 

Telephone: (207) 941-9494                Cell Phone:  (207)745-7390

Dates of Class: _____________________________
Class Times: _______________________________

     Drivers Edge School is pleased that your son/daughter has enrolled in this session of Drivers Education.  This 30 hours of classroom instruction will be on the above listed dates and class times. 
     The course fee is __________(please call for current price) plus $10.00 for permit, which includes 30 hours of classroom instruction, 10 hours of behind-the-wheel instruction, and also includes class handouts, testing materials, Maine Motorist Handbook, and Course Completion Certificate.  The Secretary of State requires a $10.00 permit fee in addition to the course fee.
     Required with the application is a $100.00 deposit.  The balance is due the first night of class.  Make check payable to Drivers EdgeAn original birth certificate with one copy must accompany the application and a copy of the student's social security card.  The original birth certificate will be returned to you the first night of class.  P.S. - You may call us and arrange to bring these items in to us before your class.
     Should the student miss classroom time, they would have to make up the missed class during the next course scheduled. The State requires the exact class missed be completed before a completion certificate is issued.
     Parent and student understand and agree that if the student fails the final exam three (3)  times, he or she will have to repeat the classroom portion of the course.  At no time will the student be allowed to exceed a maximum of six (6)  months to complete this course.
     If the student fails to keep a driving appointment, a $35.00 missed appointment fee will be collected prior to any further driving time.  (You may cancel a driving appointment with a 24-hour advance notice.)  Missed appointments cause significant scheduling problems for staff and students.  Please make sure you meet all your set appointments on time.

Important for the first class:  Please bring:
1.  Prescription glasses or contact lenses, if you wear them;
2.  A 3-ring binder notebook for all the handouts and workbook pages;
3.  A black pen and highlighter marker;
4.  And most of all, a good attitude that is ready and willing to learn!

We look forward to meeting you and spending time with you in class and behind the wheel.  We want our time together to be challenging, as well as enjoyable for you.  Should you have any further concerns or questions, we would be more than glad to answer them.

Sally A. King/Owner           (207) 941-9494 
(please keep this page for your records)


STUDENT APPLICATION

I understand this course requires that I complete a minimum of 30 hours of classroom instruction, as well as 10 hours behind-the-wheel instruction.  Parents are required to participate in the training during this course.  Students will be evaluated by test scores, quizzes, and study guides.  These are taken from the Maine Drivers Manual and Responsible Driver textbook.  Homework is a requirement.  Should the student miss classroom time, they would have to make up the missed classes during the NEXT course scheduled.  Students must complete the course with an 80% passing grade and get at least an 80% on the final test.  A $100.00 deposit is required with this application, and the balance is to be paid by the starting date of class.  We accept Visa, MasterCard, and Discover credit cards.

REFUND POLICY

REFUNDS:  The deposit is non-refundable.  You may drop the course and receive 100% refund of the balance of the tuition, which does not include the $100.00 deposit.  The refund is good up to and including the first class.  After this point there will be no refund.  You may return and finish the course at a later date not to exceed six (6) months from the date of this application.  After this you must reapply and repay the current course fees.

RULES AND REGULATIONS

  • Motor Vehicle Violations:  Students are not allowed by law or class policy to operate a motor vehicle on public roadways, other than in the driver education program.  Any violation will result in removal from the program and no refund will be given.

  • Alcohol and Drugs:  Any student exhibiting the effects of drugs or alcohol will be removed from the program and no refund will be given If in the judgment of the instructor the student is mentally or physically incapable of safe operation of the vehicle, the student will be refused permission to drive.

  • Student Behavior:  Driver education is a serious course of study involving the present and future safety of the participants.  Any student who is disruptive and disorderly will be removed from the program and no refund will be given.

  • Personal Hygiene:  Students must be clean and appropriately dressed according to reasonable standards.  When working in a close environment like an automobile, it is important that good personal and oral hygiene is maintained.

  • Smoking Policy:  No smoking will be allowed at any time during class or behind-the-wheel instruction.

We agree to abide by the terms and conditions outlined above.

Student's Signature: ______________________ Date: _________________

Parent's Signature: _______________________ Date: _________________

(Page 1 of 2 to be filled out and mailed)


DRIVERS EDGE

STUDENT APPLICATION

Name: _______________ ______________ ___________
Last First Middle
Mailing Address: _______________ ______________ ___________ _____
Street City State Zip
Phone: (___)___________ Social Security #: ________________


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)

DRIVERS EDGE
Bangor ---Hermon---Hampden---Orono
Telephone: 941-9494

PERMISSION SLIP

I, ________________________, agree to the Driver Edge School policy as described in the previous 2 pages and agree to abide by all rules.  I fully realize that any violation of this policy may lead to my permanent dismissal without any refund.

STUDENT NAME: ___________________________________  DATE OF BIRTH: _______________
STREET ADDRESS: ________________________________________________________________
TOWN/ZIP CODE: ___________________________________  SS#: _________________________
SIGNATURE: _____________________________________________________________________


My son/daughter has my permission to be enrolled in the Driver Education Program at the Drivers Edge School and has read and understood the school rules:

PARENT/GUARDIAN NAME: ________________________________________________________
STREET/ADDRESS: ________________________________________________________________
TOWN/ZIP CODE: ___________________________________   TELEPHONE: __________________
SIGNATURE: _____________________________________________________________________

Please list the days and times your son/daughter is available to drive. Remember, driving will commence during the 2 weeks of 30 hours of classroom time.
Sunday __________________  Monday ________________  Tuesday _______________
Wednesday _______________ Thursday _______________   Friday _______________
Saturday _______________

You will be notified of the date and time for Parent's Night, and you must make arrangements to attend as this will meet the Bureau of Motor Vehicle requirement for parent involvement so your son/daughter will be able to receive their driving permit.

Student must be on time and attend all classroom time. Any absence must be made up when the exact class that was missed is scheduled in the next session of Driver Education.

Do you have any of the following medical conditions:   Yes  o   No  o
If yes, check which condition below: 

Epilepsy/Seizures  o                Diabetes  o                             Heart Trouble  o
Limb Amputation  o                Paralysis  o                 Blackouts/Loss of Consciousness  o
Stroke/Shock  o                      Mental/Emotional  o                Parkinson's Disease  o
Other condition, please explain on paper  o
Please Note:  If you have been subject to any of the above physical conditions, it may be necessary for you to provide additional information in order to process your application.