Registration Form

Private Driving Lessons Enrollment Form

Student Information (TDLR Required)

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 hours desired*: Student Full Name*: Date of Birth*: Student Email*: Driver’s License*: Street Address*: Student Phone*:

Verified Enrollment Signature*

By completing this section, the adult student 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.

Signer Initials:* Verified Signature Name:*

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.