Driver Education Program
SUMMIT DRIVING SCHOOL
410-247-9083
FALL SESSION DRIVER EDUCATION PROGRAM
FEE: $395.00
(To be submitted to Mr. B. McDivitt)
October 15 - October 26

Name: ________________________________________________________________

(last) (first) (middle)

(NAME SHOULD BE EXACTLY AS IT APPEARS ON BIRTH CERTIFICATE)

ADDRESS: ____________________________________________ ZIP __________

(City) (State)

PHONE ____________ DATE OF BIRTH _________________ AGE _______

(month, day, year)

SR. JR. SOPH. FR. (circle present grade)

PARENT’S PERMISSION

My son ______________________________ has my permission to participate in the Driver Education Program sponsored by Mount St. Joseph High School. He is 15 ½ years of age or older.

I understand that, if accepted, he:

  • Must attend 10 – 3-hour classroom sessions as scheduled after school.
  • Must have 6 hours of behind-the-wheel driving instruction during after school hours and/or on weekends as scheduled by the instructor.
  • Has no mental or physical disability that would prevent the issuance of a Certificate.

PARENT’S SIGNATURE: ______________________________ DATE: _____________

NOTE: The fee of $395.00 must be paid at the time of registration. Payment must be made by check or money order payable to: Mount Saint Joseph High School. Refunds cannot be made after the first regularly scheduled classroom session.

This application must be filled out accurately and completely.