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Krupinski Driving School
Thank you for your patience as I get drivers scheduled. ONLY fill out if Your or your CHILD has a VALID PA Permit!
DUE TO HIGH DEMAND, I AM CURRENTLY ONLY TRAINING STUDENTS IN THE DOVER, SPRING GROVE, AND HANOVER SCHOOL DISTRICTS.
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Email
*
Your email
Parent/Guardian Name
*
Your answer
Parent/ Guardian Cell Phone Number (Use dashes please)
*
Your answer
Student Name
*
Your answer
Student Cell Phone Number (Use dashes please)
*
Your answer
Student goes to which School District?
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Your answer
What is the Student's Permit number (Must have PA Permit in order to sign up for driving lessons!!)?
Your answer
What is the "Test Eligibility Date" on Student's PA Permit? (Located in front center of permit)
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MM
/
DD
/
YYYY
How many hours out of the required 65 hours of driving practice has the student completed?
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Your answer
Has the student completed the required 30 hour classroom/Virtual Drive instruction? (for more information on the Virtual Drive visit
www.krupinskidriving.com
)
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Yes
No
I schedule instruction times via text. If you prefer a phone call, please indicate below.
*
Text is ok
I prefer a phone call
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