THAYER DRIVER EDUCATION CENTER 

SAFE DRIVING PRACTICES PROGRAM

FEES:       

Eight hour Drug & Alcohol Awareness
$125.00
Optional – Additional services available:  
Each additional hour driving: $65.00ea

Testing at Thayer Ed Center

(includes off-site testing fee and 2 hours behind the wheel as required by DMV only if permit is August 1, 2008

 $180.00

CLASSES MUST BE COMPLETED WITH IN 3 MONTHS OF THE FIRST CLASS ATTENDED

CLASSES ARE HELD ON SATURDAYS 8AM-12PM.

YOU MUST ATTEND TWO SATURDAYS IN A ROW TO COMPLETE THE PROGRAM

You may register on-line here or print this page (click here for a printable form) and mail it to:

Thayer Driver Education Center  45 Padanaram Road, Danbury, CT 06811
 

ALL CLASSES AND DRIVING HOURS MUST BE COMPLETED WITHIN ONE YEAR OF REGISTRATION

                   

  Printable Form

    

SCROLL DOWN TO CONTINUE APPLICATION
Please provide the following information:

SAFE DRIVING PRACTICES PROGRAM                                                      

Full Name    Date of Birth  
Street Address   Address (cont.)
City    State/Province
Zip/Postal Code                       Social  Security Number 
Home Phone                         Cell  Phone
E-mail

 

 

  FEES PAID
CLASS $125.00

Off-site test processing fee including 2 hrs driving ours.only if permit is after August 1, 2008 $180.00
_____ Optional additional driving hours @ $65 per hour: # hrs.    x $65 =         
                                                                                 TOTAL PAID $               

Credit Card Number   

Name on Credit Card 

Expiration Date   -- mm/yy      

SCROLL DOWN TO CONTINUE APPLICATION

Parent Permission Agreement

                                     You may print this form out  Printable Parent Permission Form and send or mail it in OR you may fill it out here and submit it on-line.

This health information must be received before the student has his/her first driving hour.

I give permission for Student's Name  Social Security Number

to take Driver Education classes.  I understand that all scheduled driving times must be kept and that failure to keep a scheduled appointment without 24 hours advance notification will result in a charge of $35.00 per hour. Also, I understand that if my child shows up for a scheduled appointment and does not have their Learner’s Permit with them I will also be charged a fee of $35.00 and my child will not be able to drive. In addition, I understand that all classes and driving hours must be completed within one year of registration or 3 months for Drug and Alcohol Program

 

Parent's Signature      Telephone Number 

By entering your name in this box, you are bound by Federal Law Sec. 221wwab Rev.211a as if you had signed a hard copy of this document.

Print Name in box      Relationship  Enter Date  -- mm/dd/yy

Please check below any handicaps or limitations that the student may have:

Serious Illness
Hearing problems
Rheumatic fever
Vision problems
Epilepsy		 Diabetes
Fainting
Handicapped
Learning disability
Heart condition/murmur
 

If you have checked "Yes" to any of the above, please explain:

Does the student take any medication regularly?

Yes
No
If yes, what is it? Describe below

Do you consider the student capable physically, mentally, and emotionally to drive a car?

Yes
No

Do you wish a conference with the Driver Education Instructor?

Yes
No