STUDENT INFORMATION Please Print

STUDENT INFORMATION Please Print

Utah Driving School

122 North Center Street, American Fork, UT 84003

(801) 709-7611

STUDENT INFORMATION – Please Print

Learner permit #______

______

(Legal Last Name) (First) (Middle)

Address: ______

(Street) (City) (Zip Code)

Home Phone: ______Student Cell Phone: ______

Best Correspondence E-mail Address: ______

Birth Date: ______- ______- ______Age: ______

Month Day Year

How did you find out about UtahDrivingSchool:______

PARENT INFORMATION – Please Print

Parent/Guardian Name______

Cell Phone______Home Phone______

Best Correspondence E-mail Address: ______

1. Are there any medical conditions that would pose a concern with the Student’s behind-the-wheel instruction (i.e. epilepsy, asthma, color blindness, hearing loss)? YES NO

If Yes, please explain______

2. Has the Student performed any behind-the-wheel driving prior to attending our school?

YESNO

If Yes, approximately how many hours? ______

______

Parent Signature Student Signature

______

Date

FOR OFFICE USE ONLY

Tuition:______

Date Amount/Type of Payment Receipt #

Student Contract, Policy, and Code of Conduct

This agreement is between UtahDrivingSchool and ______

Student Printed Name

UtahDrivingSchool provides: 18 hours classroom instruction (9 days, two hours per day); 6 hours behind-the-wheel driving instruction; and 6 hours observational instruction.

It is the sole responsibility of the student and/or parents to schedule ALL instructional driving and observing hours.

Requirements:

  • The student must be at least 15 years of age before classroom instruction.
  • Tuition must be paid in full before the student can commence instruction.
  • The student must have a current, and valid, Utah Learner Permit in order to perform behind-the-wheel driving instruction.
  • The School requires a copy of the Student’s Utah Learner Permit.
  • A student may request a refund if they withdraw within one week of registration. A $50.00 service charge will be assessed, in addition to any behind-the-wheel observation costs incurred before withdrawal. UtahDrivingSchool charges $50.00 for any bounced check(s).

Attendance: Regular attendance of 18 classroom hours (9 days, two hours per day) is mandatory, as required by the State of Utah.

  • Students are required to attend each scheduled classroom session and all driving/observing appointments.
  • Students are required to be on time for class and driving/observing appointments.
  • The Parent or Legal Guardian must have any absences pre-excused by the Instructor.
  • Any absences from a classroom session will have to be completed by the student at a future classroom session.
  • Students must complete the course within one (1) year to the date of registration. If the course is not completed, the student must repay the full registration fee and start the course over.

Fees And Penalties:

Fees:

  • Complete 9-Day Course: $285.00
  • Driving and Observation Only: $235.00
  • Private Driving Lessons: $40.00 per hour (Pick-up and drop-off are additional charges)

Penalties:

  • An additional $30.00 penalty will be charged to any student who is absent from a scheduled driving or observational session. Student is removed entirely from the driving/observation schedule. Any and all future scheduled sessions for both driving/observing are automatically forfeited. Payment is required before any re-scheduling can take place.
  • Any subsequent absences from scheduled driving or observational appointments could result in expulsion from the course without a refund. The student must re-pay the full tuition and begin the course again in order to continue.

Cancellation Policy: Cancellations are requiredno less than 24 hours in advance of your scheduled appointment. These may be done by contacting UtahDrivingSchool (1-801-709-7611) or the Instructor (1-801-597-1777 ).

Behavior: Students are expected to behave in an appropriate manner. Students are expected to respect the Instructor, other students, and school property. Disruptive or defiant behavior will not be tolerated. Students are not to use foul language or behave in a way which is offensive to others. Utah Driving has no tolerance for student consumption of alcohol, drugs, or any chemical that may interfere with your performance behind the wheel. Any indulgence while participating in this program will result in immediate dismissal with no refund.

By signing below, the student and parent agree to all terms of the Student Contract, Policy, and Code of Conduct.

______

Student Signature Date Parent/Guardian Signature Date