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Driver's
Education Application |
Directions:
1) Print this form 2)Fill in your information, 3)Fax
to (510) 886 - 4408 4) Call with your credit card number or
Mail (with personal check or money order) to:
Bay
Area Driving School
1070 A Street
Hayward, Ca 94541
If
you have questions, please call: (510) 886-1016
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| Complete
Legal Name |
(Please Print Legibly) |
First:
|
Middle:
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Last:
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 |
Address:
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City:
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Zip
Code:
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Phone:
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Birthday:
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Cell Phone :
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High School:
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"I
have my Parent / Guardian's permission."
| ____________________ |
_______ |
| (Parent or Guardian's Signature) |
(Date) |
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*
Cancellation of Driver Training appointment must be made
24 hours prior to
scheduled appointment. Failure of 24 hour notice will result
in $40 cancellation fee.
**$50 Admin. fee for Incomplete Dr. Ed. or Dr. Ed/Trng.
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Class Location (circle one): HAYWARD or UNION CITY
First Day of Class:______________
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Please
do not write below this line |
|
For
Office Use Only |
| Date
Paid |
Amount
Paid |
| Check
No. |
Cash
Receipt No. |
| Visa/MC |
Exp. |
| Card
Holder Name |
| Payment
#2 |
Date |
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