St. Mary's High School Driver Education Permission/Registration Form Fall 2020
This information will be used to complete your certificate, be sure it is correct!
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Last Name *
First Name (Full) *
Number / Address *
City / Town *
Zip Code *
Parent Email Address *
Student Email Address
Parent Phone number *
Student Phone number
Date of Birth *
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DD
/
YYYY
Permit 9-Digit ID Number (Please write as XXX-XXX-XXX) *
Parent Signature: By typing your full name on the line below, you agree to giving your son or daughter (whose information is listed above) permission to attend the Driver Education Program conducted at St. Mary’s High School during the Fall 2020 semester.  The course will commence from September 14 and continue through January 22. There will be no classes on Thanksgiving, Black Friday, and from December 20 through January 3. *
Additional Information
Must be at least 16 years of age and have a Drivers Permit at the start of the session.

* A Clear Photocopy of your Permit must be mailed to St. Mary’s High School, Attn: Driver Ed Program, 142 Laverack Ave., Lancaster, NY 14086

**If you do not have your permit at this time…be sure to bring it in on the First Day of class and submit it to your CLASSROOM Instructor. Your “Blue Card” will not be issued unless you submit the copy. ABSOLUTELY NO 5-Hour Certificates will be issued with this course (but may be offered separately).

Step #1 - Please select the one in-class time below to indicate your understanding that you must be able to attend the classroom session to enroll. *
Step # 2 - Choose the In-Car Days of the week that you will be able to attend. Driving sessions will be as follows: Monday - Friday 3:00 pm - 4:30 pm; 4:45   - 6:15 pm; 6:30 pm - 8:00 pm. On Saturdays, times will be 8:00 am - 9:30 am; 9:45 am - 11:15 am; 12:00 pm - 1:30 pm; 1:45 - 3:15 pm; 3:45 pm - 5:15 pm. *
Required
Notes - Please list any specific requests or accommodation needed here. Please note that if you can only make specific times on certain days, please make mention of those requests here.
Have you paid the $750 registration fee *
Additional Information
* If you have not paid the $750 registration fee, your check should be made payable to St. Mary’s High School and mailed to the school at 142 Laverack Avenue - Lancaster, NY 14086 (Attn: Driver Education)

Remember, we will try to accommodate everyone’s selections, but there is no guarantee!


Please contact your classroom instructor or in-car instructor directly regarding make-up sessions.

Refund Policy:
Should the student withdraw or be dismissed after the first classroom session, refunds will not be issued.


Makeup Policy:
For missed classroom sessions, homework will be provided for the student to cover the materials missed. For missed driving lessons, each missed lesson will incur a $30 fee that will be made up near the end of the course at an agreed upon time.


Contact Christopher Hoffman at choffman@smhlancers.org with any questions!


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