Segment 2 Contract Please enable JavaScript in your browser to complete this form.Classroom Location? *Zoom Online, Swartz Creek classroomZoom Online, Genesee Christian, BurtonZoom Online, Big Rapids High SchoolStarting Date and Time *DateTimeStudent Name *FirstMiddleLastStudent Birthdate *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192013 digit Level 1 license numberName of Parent or Guardian *FirstLastAddress *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeTotal cost for SEGMENT 2 ONLY is $60.00. Class size may be limited based on enrollment and registered and paid in full students will be given first preference. *I understandRefund Policy-If a student cancels at least 7 days prior to the first day of class, 100% of the cost paid will be refunded. After that, no refund will be given. In case of misconduct, no refund will be given and student may be expelled. *I understandA minimum of 30 hours of supervised driving, including two hours of nighttime driving, on a Level 1 license that has been held for at least three continuous months must be completed before a student can be accepted into Segment 2. Supervised driving is defined as driving with a licensed parent, guardian or parent designee age 21 or older. The parent or guardian certifies that the student has completed this. *I certify this statementStudents are required to "attend" each scheduled class at the scheduled time. If a student fails to be in the meeting room for the entire duration of the class, it will count as an absence. Once the Online "in-class" portion is completed, the student is required, by the State of Michigan, to attend a physical class to take the final written exam. Communication will be provided as to the details for test day. This online class is approved by the State of Michigan, and students will receive their Segment 2 Certificate of Completion once the student has successfully completed the requirements for Segment 2. *I understandCourse Work-6 hours of classroom instruction will be given to each student. Students who satisfactorily complete the instruction will receive a SEGMENT 2 Michigan Driver Education Certificate. The SEGMENT 2 Michigan Driver Education Certificate must be taken to a Secretary of State office in order to apply for a level 2 restricted license. A student can not legally drive using the Segment 2 Certificate of Completion. Major Driving School LLC will provide the textbook and all the materials needed for the course work. *I understandNotice Statement: This driver education provider is required to be certified by the Secretary of State. If you have any complaint that cannot be settled with the provider, please complete the Driver Education Complaint form found under “Driver Programs Division” on the Department of State website; www.michigan.gov/sos. Completing driver education does not guarantee a driver’s license.Thank you.Student Signature *Parent or Legal Guardian Signature *Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Owner Digital Signature – Byron MajorDateTimeThank you for the information! Have a Blessed Day! 🙂 Leave a comment or hit submit.NameSubmit