Driver’s Education Registration Form
                                                               
                                        Circle Class   SCF    Luck     Siren    Frederic     Grantsburg
Safe Start Driving School                                                                                                                           See website for Class Dates                                            
217 2nd Avenue SW    Milltown, WI  54858                                                                                                        Orientation Date_________________________  
(715)825-4950   cell  (715) 553-0474                                                                                                                 Start Date of Class _____________________
www.SafeStartDrivingSchool.com                                                                                                                                                                  Dates Subject to Change

                                                                                                                                                                                                                                                                                   
Full Legal Name (print)__________
____________________________________________________________________________________________
                                    (as it appears on Birth Certificate)         First                                 Middle                                                 Last


Date of Birth___________________ Cell Phone #_______
______________________Parent Cell Phone#_________________________________


Address__________________________________
______________________________________________________________PO Box  _________


City________________________________________________________
_______________State_____________Zip_________________________


Parent/Guardian Name(print)___________________________
_____________________________________________________________________


Parent/Guardian Signature___________________________________________
_______________________________________________________

Classroom Fee $100.00   
Online Transfer Fee $125.00


Mail Registration and payment to:   Safe Start Driving School  217 2nd Ave SW  Milltown, WI  54858   

Classroom fees are non refundable after 2nd class                            
After registering, assume to be in the class unless otherwise notified
Parent and Student are required to attend Orientation

Behind the Wheel $315.00 payable when driving instruction begins   Payment Plan Available/Prices Subject to Change
 


Office Use Only:
Payment Received Date _____
________________________Amt______________________________Check#_____________________________
              
                                         By signing above you are releasing Community Education, participating School District and their
                            
                                               employees from any liability due to injury or lost/misplaced personal items.

Mail this portion with payment
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Cut off and Save

Driver’s Education Registration Form                                               
Safe Start Driving School                                                                  Class Location     SCF    Luck    Frederic   Siren    Grantsburg    
217 2nd Avenue SW Milltown, WI  54858                                              
                             Orientation Night _______________ 6pm
(715) 825-4950
  cell (715) 553-0474                                                                                  Parent & Student must attend
www.SafeStartDrivingSchool.com                                                                               
                                                                             
                              See web site for list of Class Dates Or Contact Community Ed
                                                                                                                                    
        Dates Subject to Change
Classroom requirements:                                                                                                         

Minimum age requirement:  15 yrs by the first day of class   
Student must attend classes consecutively and only 2 classes may be missed.  Missed classes must be made up.
Classroom fees are non refundable after the 2nd class.  But may be transferable.
After  registering, assume to be in the class unless otherwise notified
Class dates may change
Parent and Student are required to attend Orientation  (approx. 2 hours)
Behind the Wheel requirements:  
Student must be 15 ½ yrs old and enrolled in Driver’s Ed
Pass written test at DMV for WI Temporary Permit
Permit must be held for 6 months before WI Drivers License