Driver’s Education Registration Form SCF Luck Siren
Safe Start Driving School (Circle School Location) Frederic Grantsburg
217 2nd Avenue SW Milltown, WI 54858 Orientation Date______(715)825-4950 Start Date of Class ______
www.SafeStartDrivingSchool.com See website for list of Class Dates Or Contact Community Ed
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
Mail Registration and $75.00 Classroom payment to:
Classroom fees are non refundable after 2nd
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
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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. But may be transferable.
After registering, assume to be in the class unless otherwise notified
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 01/14