Driver Ed. Application
This Course consists of 30 hours of classroom instruction, 3 ½ hours of road driving, and 5 hours on the Driving Range.

There is a $150.00 class fee for Drivers Ed. Please pay the fee at the Ben Lomond Bookstore and give the receipt to Mr. Wakley. If a student is on Fee Waiver ask the Book Keeper at the Bookstore for a receipt showing the fee waived.

Due to State Regulations regarding classroom time, any student missing 3 hours of class will be dropped from the class and the fees will be forfeited.  Fee Waiver students will be required to pay for the next class they take.  Keeping this in mind it is imperative that all students complete the class and meet all schedule commitments.  Our goal is to help students acquire the skills, attitudes and knowledge necessary to become a competent driver. A $25 fee is required to make-up a Road or Range schedule missed.
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First Name: Jazmin *
Middle Name:
Last Name: Perez *
Student 1000#:  100055191 *
If you do not attend a school in Ogden School District, please type in the name of your school.
1003 E 125 S, Ogden UT 84404 *
11/25/2006 *
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Place of Birth: Ogden *
Gender: Female *
Grade: 10th *
Cell Phone Number: 801-781-0482 *
Student phone number if available, if not please type a parent phone number.
Permit Number:
If you already have your permit please type in your permit number.
Expiration Date for Permit:
If you already have your permit please type in your expiration date.
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Do you have any physical disabilities or concerns other than vision that may affect your driving? No *
Class Time:2:45 PM *
Parent/Guardian Signature
By signing you give your student permission to participate in the Drivers Ed Class.
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