For Office Use ONLY: date received:_______________
copied:______ paid:____________ cash / check#____________ receipt#____________
_______________________________________________________________________
First Middle Last
Birth Date:____/____/____
Mo. Day Yr.
_______________________________________________________________________
Address City Zip
Home Phone:(____)__________________ Cell Phone:(____)__________________
E-mail address:______________________@_____________
What school do you attend?_______________________________________________
How did you hear about this course?__________________ From whom?____________
Type of Instruction Desired:
Please check the package that you would like to purchase.
The rate for the Behind the Wheel driving is $57(55 cash) per hour.
|
No. |
Package |
Price |
X |
|
#1 |
*9 hours of “Behind the Wheel” driving only. |
$510/$495c |
|
|
#2 |
*6 hours of “Behind the Wheel” driving only. |
$340/$330c |
|
|
#3 |
*3 hours of “Behind the Wheel” driving only. |
$170/$165c |
|
|
#4 |
24 hours of classroom instruction. (In a teenage classroom setting.) |
$102/$100c |
(If applicable)
What course are you interested in? Date:__________________ Time:_____________
Check the class location: ____ Burton ____ Swartz Creek
*Every 10 minutes of trip time will be $5. A TRIP CHARGE may be added to drive depending on the pickup and drop off location.
All or half of the cost should be paid on the first drive. Any additional practice driving will be $55 per hour. Most clients average 6 to 9 hours of instruction.
Course Work-Package #4 only
24 hours of classroom instruction. Major Driving School will provide the textbook and all materials needed for the course work.
Method of Payment
Complete payment can be made by cash or check. Before any instruction, classroom or “Behind the Wheel” will be given, payment in full or half must be received. Any returned checks will be assessed a $20 charge.
Refund Policy-Packages #1, #2, and #3 only
If a student cancels before the first day of class, 100% of the cost paid will be refunded. After the 1st or 2nd day of class, 75% will be returned. After the 3rd, 4th, or 5th class day, 50% will be refunded and after the 6th class day, you will be responsible for the entire fee. No refund will be given for individual “Behind the Wheel” lessons or individual classroom refresher course lessons.
The student certifies that he/she is at least 18 years of age by the first day of class and has no physical handicaps that will interfere with driving an automobile.
_________________________ ______________________
Student Signature Date
_________________________ ______________________
Major Driving School Official Date
Notice Statement: “This school is required to be licensed by the Michigan Department of State, Driver Training & Testing Programs. If you have a complaint which you cannot settle with this school, write: Michigan Department of State, Driver Training & Testing Programs, Lansing, MI 48918. Completion of driver trai