Oconomowoc BTW Call List
This form is to request additional BTW lessons, beyond what can be scheduled online.  We will contact you ONLY USING THE CONTACT INFORMATION you are providing in this form, so please review for accuracy before submitting.  Opportunities may be short notice, so responding back quickly will be to your advantage.
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Email *
DO NOT USE THIS FORM TO SUBMIT CANCELLATIONS!  Cancellations must be submitted by email, text, or phone (262)220-7792 with 24 hours notice to avoid the late cancellation fee.   
Student First Name *
Student Last Name *
Primary contact phone (must be TEXT capable) *
Does this phone receive text messages
Clear selection
Preferred contact method *
Instruction Permit ISSUE DATE *
MM
/
DD
/
YYYY
16th Birthday Date *
MM
/
DD
/
YYYY
Target Date *
Target Date to get License (MUST be at least 6 MONTHS from issue date)
MM
/
DD
/
YYYY
BTW lesson summary *
0
1
2
3
4
5
6
Not Sure
BTWs Completed/Scheduled
BTWs NEEDED
School
Clear selection
Virtual *
Please select "yes" if you are either part time/full time virtual or Home schooled AND have the ability to do lessons earlier than 3p. Please enter the times you are available in the "Availability Comment" field
Required
Availability
Please enter the times of day, days of week that you have availability, before 3p weekdays
Comment
Please provide us information about your situation, and what you are trying to accomplish. Please include dates you already  have scheduled and what you are looking to try to add (and if applicable, by when)
No-Show Call List
If you are able to be at the pickup location within 5-10 minutes, you can request to be put on our No-show call list, so our instructor may contact you in case of a No-show.
A copy of your responses will be emailed to the address you provided.
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