- Behind the wheel program teen ages 15-1/2 -17-1/2
- If you have your permit and you need the 6 hour behind the wheel training
- This is the program for you.
- We offer four private lessons pickup and drop off from home in most areas
A Teen Behind The Wheel Training Program, 6 Hours,
- If you have your permit you will need
- 6 hour behind the wheel course
- 4 private lessons
Register Here
If you have your permit and between ages of 15-1/2 -17-1/2 then Alpha program is for you, four private lessons, and flexible hours. Any questions call our office at {760-810-0754 }
Alpha Driving School
Student Information Sheet
DATE: _______/________/_________
STUDENT NO: ____________
FULL NAME: _____________________________________________________________________________________
FIRST
MIDDLE
LAST
ADDRESS: ____________________________________________ CITY: ________________________ ZIP: _________
MAILING ADDRESS: _____________________________ CITY: ___________________________ ZIP: ____________
MAJOR CROSS STREET: _______________________________ AND: ______________________________________
D.O.B.: _____/_______/_______
AGE: _______
HOME PH: _____ - ______________
GRADE: ______
SCHOOL: ________________________
WORK PH: _____ - _______________
CELL: ____ - _____________
EMERGENCY NO: _____ - _________________ EMAIL: ________________________________________________
HOW DID YOU HEAR ABOUT US: [ ]
NEWSPAPER
[ ]
YELLOW PGS
[ ]
FRIEND
[ ]
WALK IN
[ ]
SCHOOL PAPER
[ ]
OTHER
PARENT/GUARDIAN(S) NAME: ____________________________________________________________________
STUDENT MEDICAL CONDITIONS: _________________________________________________________________
ALLERGIES: __________________________________ MEDICATION TAKING: ______________________________
IMPORTANT PLEASE READ: YOUR STUDENT IS REQUIRED TO COMPLETE THEIR DRIVERS EDUCATION AND TRAINING WITHIN 6
MONTHS OF REGISTRATION. IF MORE TIME IS NEEDED IT WILL BE SUBJECT TO AN ADDITIONAL CHARGE. IF YOUR STUDENT
NEEDS TO CANCEL A DRIVING APOINTMENT, A 24 HOUR NOTICE OF INTENT IS REQUIRED. IF NOTICE IS NOT GIVEN, OR THE
STUDENT FORGETS THE APPOINTMENT OR DOES NOT HAVE IN THEIR POSSESSION A VALID PERMIT OR NOT AT
PREARRANGED PLACE OF PICKUP, A FEE WILL BE CHARGED FOR THE FORFEITED LESSON. PARENT/STUDENT AGREES WITH
ALL FEES THAT MAY BE APPLIED IF I/WE DO NOT COMPLY WITH ALPHA DRIVING SCHOOL TERMS AND CONDITIONS AND
THIS INFORMATION SHEET. ALL APPOINTMENTS ARE SUBJECT TO AVAILABILTY. ALPHA DRIVING SCHOOL HAS THE RIGHT TO
MAKE CHANGES TO YOUR STUDENTS DRIVER EDUCATION OR TRAINING SCHDULE AT ANYTIME WITHOUT NOTICE. STUDENT
MUST BE ON TIME NO MORE THAT 15 MINUTES PAST THE SCHDULED TIME, OR THE STUDENT WILL NEED TO RESCHEDULE AND
AN ADDITIONAL FEE MAY APPLY. STUDENT MUST WAIT FOR 30 MINUTES FOR INSTRUCTOR TO ARRIVE DUE TO DELAYS IN
TRAFFIC, ROAD CONSTRUCTION, ACCIDENTS, OR STUDENTS.
I HAVE READ, UNDERSTAND, ACCEPT AND AGREE WITH THE CONTENTS OF THIS FORM. I CERTIFY UNDER PENALTY OF
PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE INFORMAITON ENTERED BY ME ON THIS FORM IS TRUE
AND CORRECT. I HAVE ALSO READ, RECEIVED, AND UNDERSTAND ALPHA DRIVING SCHOOL COMPANY TERMS AND
CONDITIONS.
PARENT / GUARDIAN SIGNATURE: ______________________________________________ DATE: ____________
18077 outer Hwy 18 S., Ste. 300 Apple Valley Ca,92307
TEL: (760) 792-0783
www.alpha-ds.com
FAX: (760) 792-1780W.johnson@Alpha-ds.com