REGISTRATION

The following form must be filled out and returned with a deposit of $50.00 to reserve your place in the class.

Please email (renee@coastalcarolinadrivingschool.net) with any questions.

NOTE: Driving times are scheduled after classroom time is completed. Behind the Wheel instruction is scheduled during the week and on Saturday morning. Driving sessions are for 2 hours over 3 days (not consecutive).

** When you register, a $50.00 deposit is required in order for your registration to be completed . NO seat is reserved without the deposit or payment in full!
For convenience go to the "Pay for Classes" page and use your Debit, Visa, Master Card or Pay Pal. You will ONLY receive a confirmation from paypal for your payment. PRINT the page below before submitting.

Please be advised, classes may be rescheduled at any time. This form is for 30 hours classroom & 6 hours BTW only. ALL boxes must be completed or it will not be delivered to inbox!! Print page before submitting (right click & print)

* Indicates required field

Select a class date *

Name as on Birth Certificate (MIDDLE and LAST name in same box) *

First

Last

Address (street address, no PO Box) to be printed on PERMIT *

Line 1

Line 2

City

State

Zip Code

Country

Email *

**PHONE NUMBERS,** DATE OF BIRTH, SCHOOL- (MUST BE COMPLETED) -- *Comments, or learning/testing issues. *

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