Traffic Safety Education Application
Registration Requirements: Completed application with DOL permit number and $500 payment to be registered in a course.
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Driver’s Ed Program Summary  
CLASSROOM:  (Set schedule)
35 hours of TSE Curriculum Instruction

BEHIND-THE_WHEEL/ DRIVING:   (by appt)
6.0 Hours of In Car Instruction
4.0-6.0 Hours of in Car Observation
**Student have 12 Months from the 1st day of class to complete all drives**
Check Sessions: *
Student Last Name *
Student First Name *
Student Middle Name *
Student Home Address: *
 Student Email Address:  (School email) *
Student Birthdate *
MM
/
DD
/
YYYY
 Student Telephone Number (or best contact number) in this format XXX-XXX-XXXX *
Parent Name *
Parent Email *
Parent Telephone Number (in this format XXX-XXX-XXXX) *
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