A Careful Turn Driving School, LLC

1117 Emerald Forest Lane, Davison, MI, 48423

Office Hours: Monday – Friday, 10 A.M. to 6 P.M.(810) 214-1137

Department of State Certification # P000528

SEGMENT 2 CONTRACT

Please Print

Program Number #______Classroom Location:______Dates of Class:______

Student ______

Name Last First Middle Age Date of Birth

Address ______City______Zip ______

Home Phone ______Work Phone (Parent or Guardian) ______

Parent’s Name______Home Phone (Parent)______

Address ______City______Zip ______

COURSE PROVISIONS

Course Provisions:A Careful Turn Driving School will provide a minimum of 6 hours of classroom instruction provided by a certified instructor. Classroom instruction shall not exceed 2 hours per day.

Terms:For a student to participate in segment 2, verification must be received that the student has completed a minimum of 30 hours of driving (including 2 hours at night) with a licensed parent or guardian (or parent designee) on a level 1 license, which has been held for not less than 3 continuous months.

The parent or guardian agrees to pay $35.00, which needs to be paid by or on the first day of class. This fee covers all materials. Payments may be made by cash, check, money order, or credit card. All checks and money orders will be made out to A Careful Turn Driving School, LLC.

The student must complete all assignments and pass the State Test with a 70% or higher.

In the case of a student absence, the student must make up time in another Segment 2 course being offered. This may be done during a different Segment 2 class being offered.

Return Policy: If for any reason you decide to withdraw from the course before the first day of class, all monies paid will be refunded. If you withdraw from the class after the class has started, no refund will be issued.

Notice:This provider is required to be certified by the Secretary of State. If you have any complaint which you cannot settle with this provider, write: Michigan Department of State, Driver Programs Division, Lansing, MI 48918. Completion of driver education instruction does not guarantee qualification for a driver license.

CERTIFICATION: I certify that the information on this form is true and accurate to the best of my knowledge.

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Student Signature Parent or Guardian Signature

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School Representative Signature Date of Contract