Safe Start Driving School Driver S Education

Driver’s Education Registration Form SCF Luck Siren

Safe Start Driving School (Circle School Location) Frederic Grantsburg 217 2nd Avenue SW Milltown, WI 54858 Start Date of Class ______(715)825-4950 See website for list of Class Dates Or Contact Community Ed www.SafeStartDrivingSchool.com Dates Subject to Change

Full Legal Name (print)______(as it appears on Birth Certificate) First Middle Last Date of Birth______Home Phone #______Cell Phone#______Address______PO Box ______City______State______Zip______

Parent/Guardian Name(print)______Parent/Guardian Signature______

Classroom $75.00 Behind the Wheel $315.00 Total $390.00

Safe Start Driving School Mail Registration and $75.00 Classroom payment to: 217 2nd Ave. SW Milltown, WI 54858 Classroom fees are non refundable after 2nd Class After registering, assume to be in the class unless otherwise notified

Behind the Wheel $315.00 payable when driving instruction begins Payment Plan Available/Prices Subject to Change

Office Use Only: Payment Received Date ______Amt______Check#______By signing above you are releasing Community Education, participating School District and their employees from any liability due to injury or lost/misplaced personal items. Mail this portion with payment ------Cut off and Save Driver’s Education Registration Form Complete for your information Safe Start Driving School School Location SCF Luck Frederic Siren Grantsburg 217 2nd Avenue SW Milltown, WI 54858 Dates of Class______(715) 825-4950 Orientation Night 6pm______Parent & Student must attend www.SafeStartDrivingSchool.com See web site for list of Class Dates Or Contact Community Ed Dates Subject to Change Classroom requirements: Minimum age requirement: 15 yrs by the first day of class Student must attend classes consecutively and only 2 classes may be missed. Missed classes must be made up. Classroom fees are non refundable after the 2nd class After registering, assume to be in the class unless otherwise notified Minimum class size 15 Class dates may change Parent and Student are required to attend Orientation (approx. 2 hours)

Behind the Wheel requirements : Student must be 15 ½ yrs old and enrolled in Driver’s Ed Pass test at DMV for WI Temporary Permit Permit must be held for 6 months before WI Drivers License Must receive 6 hours of Behind the Wheel Instruction and 6 hours of Observation with a licensed instructor Must receive 30 hours of driving experience with a legal licensed driver 10 hours at night For more information: www.SafeStartDrivingSchool.com 01/11