Teen Classroom Registration | T&D Driving Academy

Fill out all required fields and hit submit.

Only open classroom sections are shown below. If a class has filled or closed, it will not appear in the list.

Class Selection

Enrollment Option/Section*

Once a classroom section is capped by the office, it will no longer be available to select here.

PRIVATE LESSON PRICING BLOCKS

1 hr = $120 | 2 hrs = $230 | 3 hrs = $330 | 4 hrs = $420 | 5 hrs = $510 | 6 hrs = $600
Pay as you go: $120 per hour.

Number of drive lesson hours desired*

Enter a whole number from 1 through 6.

Student Basics

First Name*

Middle Name

Last Name*

Date of Birth*

Used for DL-14B and copied to the enrollment contract automatically.

Sex*

Male Female

License / Permit #, if available *

Optional for classroom enrollment.

Contact

Student Email*

Student Phone*

Parent Home Phone

Parent Cell Phone*

Notes, Questions, or Scheduling Concerns

DL-14B: Identity & Physical

SSN first (3)

SSN middle (2)

SSN last (4)

Weight

Height (ft)

Height (in)

Eye Color

Blue Brown Green Hazel Gray Black Other

If Other:

Hair Color

Black Brown Blonde Red Gray Bald White Other

If Other:

DL-14B: Birthplace & Parents

Birth City

Birth State

Birth County

Birth Country

Father Last Name

Mother Maiden Name

Residence Address

Street*

City*

State*

ZIP*

County

DL-14B: Mailing Address, if different

Mail Street

Mail City

Mail State

Mail ZIP

Mail County

DL-14B: Race & Ethnicity

Race

White Black / African American Asian American Indian / Alaska Native Other

If Other:

Ethnicity

Hispanic / Latino Not Hispanic / Latino Unknown

Verified Enrollment Signature

By completing this section, the parent/legal guardian, or the adult student of 18 or older, verifies intent to enroll and authorizes T&D Driving Academy to prepare the enrollment contract PDF. The terms are not binding until all parties agree, sign, and payment is remitted.

Contract Signed By*

Signer Initials*

These initials may be placed in the contract fields that require acknowledgment.

Verified Signature Name*

Type the signer’s full name exactly as it should appear on the enrollment contract.

Signature Preview:

Signature will appear here

Initials Preview: —

I verify that I am the person named above and that this typed name and initials may be used as my electronic signature/acknowledgment for enrollment paperwork.