Driving School Application

Mr Ross Driving School Enrollment Application:

The following 5 items must be completed:

1) To be allowed to take Driver Education, your son/daughter must have passed two High School classes the previous quarter or Guidance Counselor Written Approval

2) Must be 16 by the conclusion of the course (State law).

3) VISION: ______________N ______________F Uses glasses/contacts

Signature of School Nurse _____________________________________

4) ____ Birth Certificate enclosed (no originals please, copy only)

5) ____ Check enclosed for $635. made out to: Mr. Ross’ Driving School.

(Mail check, forms, birth certificate, to Mr. Ross’ Driving School, 12 Mercury Dr. Londonderry, NH 03053)

PLEASE PRINT FULL LEGAL NAME

Name________________________________________________________________ (First, Middle Initial, Last)

Address:______________________________________________________________ (Street, City, State, Zip)

Student Home Phone: _________________________ Date of Birth: _______________

Parent Name (s): _________________________________ Work # _______________

Mailing Address (if different): _______________________________________________

FOLLOWING MUST BE FULLY COMPLETED:

Free Periods/Study Halls/Lunch-Study: ___________________________________________ (please include ALL free periods, not just lunch periods)

DRIVING WILL NOT NECESSARILY BE DONE ON THE SAME DAY AS CLASS. CIRCLE EACH DAY YOU WILL BE AVAILABLE. It is HIGHLY RECOMMENDED that you have a free period besides lunch.

After School Driving (Circle): M T W Th F Saturday Driving: Yes___ No___

IMPORTANT: Applications are accepted on a first-come, first-serve basis and driving time availability. Student will be registered only upon receipt of completed forms, copy of birth certificate and check.

Students and parents should review the pages listed and complete each appropriate page. Any questions please call (603) 497-4553 or (603) 661-3547 (Cell)

Mr. Ross' Driving School... Have a question simply call or email us

12 Mercury Dr. Londonderry, NH 03053 call 603.497.4553 Cell 603.661.3547