Pre-registration
(Do not use this form for JDIP or teen remedial registrations.)

Pre-registering for class is an efficient way to let us know when you will be attending class and takes care of most of the registration process ahead of time.

Please fill out the below form and press the SUBMIT button when finished and we will have your registration paperwork printed out for you when you arrive at the driving school.

New students start every week.
Student information
* Required fields
Student's Full Name *
NO nicknames or abbreviations.
Street Address *
City *
State *
Zipcode *
Date of Birth *
 Month            Day    Year 		Note: student must be at least 15 years and 5 months of age in order to start class.
Gender Male or Female
Home Phone *
Student's Cell #
Parent's Names *
High School *
E-mail address
   We can send you an e-mail confirmation.
What date do you intend to start classes? *
  Month           Day      Year		 New students start every week.
Which session would you like to attend? evening class or
morning class (mainly summers)
Students can start on any Monday.  Evening classes are from 6 pm to 9:05 pm.  Morning sessions are from 9 am to 12:05 pm and typically held only during the summer.

Temporary driving permit info
The following information can be located on your photo ID. If you cannot locate this information, do not fill in this section.   Your driving instructor will gather this information before you drive with us.   Students are not required to have their temporary driving permit in order to start the classroom sessions.

License Number

This is labeled "LICENSE NO." on the photo ID. It is two letters followed by 6 numbers. EG: TX123456
Permit Issue Date This is labeled "ISSUE DATE" on your photo ID.
Permit Expiration Date The permit expiration date is labeled "EXPIRES" on the photo ID.

Emergency Medical Information
The following information can be filled in now and submitted over the internet or hand written when completing the forms when you arrive at the driving school.   It is much more efficient if you are able to fill in this information now.
Mother's Name Daytime Phone
Evening Phone
Cell Phone
Father's Name Daytime Phone
Evening Phone
Cell Phone
Other Contact Name Contact Phone
Relationship: Contact Cell Phone
Doctor's Name Doctor's Phone
Specialist's Name Specialist's Phone
Preferred Hospital
Medical conditions that we should be aware of
Directions from 1225 North Main St., North Canton, Ohio 44720 to your house for home pick up. Note: See service area (new window) for home pickup eligibility.

Comments

Monday, February 6, 2012 05:16:53 AM

Press the Submit button and wait for your CONFIRMATION page to be displayed.




Information about our secure registration