Driver's Ed Class: Session Choice: *

S11 - NOV 25 and DEC 19, 2019-JAN 6, 2020 (Holiday Class): Time 6:45-8:45 pm & Sat.'s 12-2 pm

S1 - JAN 20 - FEB 13, 2020: 4 WKS M-Th: Time TBA

S3 - MAR 23 - APR 16, 2020: 4 WKS M-Th: Time TBA

S6 - JUN 1 - 25, 2020: 4 WKS M-Th: Time TBA

S7 - JUL 20 - AUG 13, 2020: 4 WKS M-Th: Time TBA

Student Name (as on Birth Certificate - no nicknames) *

First Name

Last Name

Student DOB *

Example 3/23/2003

MM

DD

YYYY

Does student have a learning impairment? *

If yes, please understand this is a standard classroom learning environment, so attend Lesson One to see instruction plan and if good then pay on Lesson 2.

No

Yes - ADD

Yes - ADHD

Yes - Autism

Yes - Dyslexia

Yes - Sensory Processing

Yes - Other (please explain when you sign at bottom)

Student Cell

(optional)

(###)

###

####

Parent Contact phone *

(###)

###

####

Will pay on first day by *

Check

Credit Card (incl. 2.75% fee)

Cash

Check box if you agree to the following terms *

Click on first box, then tab and space bar to check all others or click each box.

Must not miss Lessons 1, 2 or 3 Permit Certificate acquisition. State allows a maximum of 5 absences that must be made up in future sessions during the next six months.

The student may not be tardy more than ten minutes, and if late, must use break time to make it up.

Refunds must be requested after Lesson 1 and prior to Lesson 2. A $25 Admin fee is non-refundable. If unable to attend entire session, a credit will be issued to attend a future session.

Progress standard mastery grade of 70 is required on unit tests and comprehensive final examinations of State Driving Laws-Signs and Driving Maneuver Theory as required by the Texas Department of Licensing & Regulation (TDLR).

Student Conduct may not cause a disruption in class and must follow the authority of the instructor at all times. A student will be dismissed for signs of drug, alcohol or tobacco use, disruptive behavior. No cell phone use unless given permission by Instructor. Students terminated for violating rules of conduct may be readmitted at the discretion of the school Director. If not readmitted, there will not be a refund available.

How did you learn about Stonepoint Driving School? *

Google Internet search

Car advertising

Friend who took this class

Postcard mail out

Facebook

Pt. Venture Golf Card

YELP!

Other