Wait-list for Driver Education Registration - Fall 2021-22
                      PLEASE COMPLETE THIS FORM ONLY IF YOU COULD NOT REGISTER FOR CLASS.  You do not need to select a day or time.  If spots open up, we will contact you with what classes become available.  

* This is a virtual class using the student's Three Village District Google Classroom account.*

In order to register, students must be a senior or junior and at least sixteen years of age. Students must have a valid learner’s permit.

Cost:  $250.00 – Once Registration is complete, you will receive a confirmation email along with payment instructions from the Athletic Office the following week.

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In order to obtain the Student Certificate of Completion (MV-285) student must complete 48 hours of the program.

* Twenty-four (24) hours of Google Classroom instruction, plus the final exam that takes place during the last lecture class.

* Minimum of twenty-four (24) clock hours of laboratory instruction is required.  
 
     - Laboratory instruction must include a minimum of six (6) clock hours of behind-the-wheel driving and a minimum of six (6) clock hours of in-car observation, with a licensed parent or guardian.
   
    - The remaining twelve (12) hours of laboratory instruction may include a combination of additional behind the-wheel instruction and in-car observation.

* All students must login on time and be visible and present for the entire Google Meet Class.

* Students must pass both portions of the program with a minimum grade of 65.

* All assignments must be completed.


                              * * All students must take and pass the final exam.* *


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Student's Last Name *
Student's First Name *
Student's Middle Initial or Middle Name (Exactly as it appears on student's permit)
DOB *
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DD
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YYYY
Student's Current Grade Level  (Registration for 2021 - 2022 Juniors will begin tomorrow, Tuesday, September 14th, pending availability ) *
Street Address (AS APPEARS ON PERMIT) *
City *
State *
Zip Code *
Phone Number *
Parent Email Address *
Student Email Address *
Student's Permit Number (9 digit number) *student must have permit by start of course*
Electronic Signature (type name below) - I hereby certify that I am the parent or legal guardian of the above student and I hereby grant permission for him/her to enroll in the Three Village Central School District Driver and Traffic Safety Education Program. I will provide a payment in the amount of $250.00 to officially enroll my child in the program once instructions are provided. *
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