Right of Way Driving School

Subtitle

 

Right of Way, LLC dba Right of Way Driving School

7201 Silver Lake Rd. * Linden * MI * (810) 635-7867

e-mail: [email protected] *  rightofwaydrivingschool.webs.com

Office Hours: M-F, 9:00 a.m.-3:00 p.m. * Department of State Certification # P000640 *

Class Location:  Linden High School * Program #

SEGMENT 2 INFORMATION SHEET

 Students must be registered by the Friday before a Segment 2 class begins.  No late registrations and no walk-ins.

Segment 2 Driver Education classes will be offered at Linden High School on the following dates:

  • October class full       Class meets after school until 4:15/4:30
  • December class full       Class meets after school until 4:15/4:30
  • February 7, 8, 9, 2018               Class meets after school until 4:15/4:30
  • April 17, 18, 19       Class meets after school until 4:15/4:30
  • June 19, 20, 21       Class meets from 8:30 - 10:30 a.m.
  •   ·         If Linden High School does not have school, (inclement weather, holiday, break, power outage, teacher Professional Development, etc.) there will be no drivers ed classes.

     ·         To register, fill out the registration form and contract, include a copy of birth certificate, level 1 license (issued from the Secretary of State) and $40.00 payment, and turn in at main office of Linden High School or e-mail to [email protected]

     ·         Please make sure completed registration form and contract have:

     o   Parent signatures, including initials on the contract

    o   Student signatures

    o   A copy of student's birth certificate

    o   A copy of student's level 1 license (please don't cut off the top left row of numbers/letters)

    o   $40.00 payment

    o   All questions answered and blanks filled in

     ·         While providing an e-mail is optional, regular e-mail updates are sent.  Reminder postcards are mailed approximately 7 - 10 days before each class begins.

     ·         Students must have had their level 1 license for at least 90 days before taking Segment 2.

     ·         Students will need to have their driving log with them on the first day of class.

     ·         All classes must have at least 6 registered students to be held.

    If you have further questions, please call or e-mail.  Thank you for your business.

     





    Right of Way, LLC dba Right of Way Driving School

    7201 Silver Lake Rd. * Linden * MI * (810) 635-7867

    e-mail: [email protected] *  rightofwaydrivingschool.webs.com

    Office Hours: M-F, 9:00 a.m.-3:00 p.m. * Department of State Certification # P000640 *

    Class Location:  Linden High School * Program #

    SEGMENT 2 REGISTRATION

    Student Name (last)____________________ (first)______________________ (middle)___________________

    Address ______________________________________ City_____________________ Zip ____________

    D.O.B.  _________________________  Age ______________  Preferred phone______________________________

    Parent/Legal Guardian Name___________________________ Parent phone_______________

    Parent e-mail_______________________________________________________

    Emergency Contact______________________________________________ Phone _______________________

    Date of class_____________________________________________________________________________________________

    ACCOMMODATIONS/MEDICAL CONDITIONS

    1.  Does the student require any special accommodations to participate in the classroom phase (i.e., test being read, interpreter, seating arrangements, etc.)?             Yes      No      If Yes, please explain:                                                     

    2.  Does the student require any special accommodations to participate in the behind-the-wheel phase (i.e., adaptive devices, an interpreter, etc.)?                Yes      No      If Yes, please explain:                                                                                                                            

    3.  Is the student taking any medications that may affect his/her ability to drive a motor vehicle safely?       Yes      No      If Yes, please explain:                                                                                                                                                                    

    4.  Are there any medical conditions that would pose a concern with the student?s behind-the-wheel instruction (i.e., epilepsy, asthma, color blindness, hearing loss)?           Yes      No      If Yes, please explain:                                                                                            

    5.  Is the student?s visual acuity at least 20/40 corrected?               Yes      No     

    6.  In the last six months, has the student had a fainting spell, blackout, seizure, or other uncontrolled loss of consciousness?  Yes      No     

    7.  In the last six months, has the student had a physical or mental condition which would affect his/her ability to drive a motor vehicle safely?             Yes      No     

    If the answer to question 5 is no, or either of questions 6 or 7 is yes, then the Parent/Guardian must provide a letter signed by the Student?s physician indicating that the condition has been corrected and/or is under control and the Student meets the physical and mental requirements for a motor vehicle operator?s license under Section 309 of the Michigan Vehicle Code, 1949 PA 300, MCL 257.309. 

    CERTIFICATION:

    I certify that all information contained within this document is true and accurate to the best of my knowledge.

    Date:                                      Student Signature:                                                                                         

    Date:                                      Parent/Legal Guardian Signature:                                                                  

    Date:                                      Right of Way, LLC dba Right of Way Driving School   

    Provider name 

    By:                                                                   Owner                                                                                         

            Signature of Provider Owner                 Title

    Payment Information:

    Cash_____ or Check #___________ (Make payable to: Right of Way)

    CREDIT CARD/DEBIT CARD (Circle which one and fill out information below)

     Name:_________________________________________________  

    ______VISA _____ MASTERCARD______DISCOVER      CARD NUMBER:_____________________________________ CV2 Code_______

    EXP. DATE:_______________      AMOUNT:_______________________

     SIGNATURE:______________________________________________________________________          

     


    Right of Way, LLC dba Right of Way Driving School

    7201 Silver Lake Rd. * Linden * MI * (810) 635-7867

    e-mail: [email protected] *  rightofwaydrivingschool.webs.com

    Office Hours: M-F, 9:00 a.m.-3:00 p.m. * Department of State Certification # P000640 *

    Class Location:  Linden High School * Program #

    SEGMENT 2 CONTRACT

     

    Student Name (last)_______________________ (first)______________________ (middle)_________________

    Address ______________________________________ City_____________________ Zip ____________

    D.O.B.  ____________________  Age ______________  Home phone___________________________________

    Parent/Legal Guardian Name______________________________ Parent phone__________________________

    Parent address ___________________________________ City________________________ Zip ____________

    Emergency Contact_________________________________________ Phone ____________________________

    Date of class_______________________________________________________________________________________

     

    SEGMENT 2 PROVISIONS                                                                                                                                                                                             

    1.     Right of Way, LLC dba Right of Way Driving School will provide a minimum of 6 hours of classroom instruction provided by a certified Michigan Driver Education Instructor. 

    2.     Classroom instruction shall not exceed 2 hours per day.

    3.     For a student to participate in Segment 2, a verification log must be received that the student has completed a minimum of 30 hours of driving (including 2 hours at night) with a licensed parent or guardian (or parent designee) on a level 1 license, which has been held for not less than 3 continuous months.  Verification log was presented to the Segment 2 instructor on or before the first classroom session.  Parent initials _________  Seg 2 instructor initials ____________.

     SEGMENT 2 TERMS                                                                                                                                                                                                           

    1.     The Parent or Legal Guardian agrees to pay the total amount of $40.00 when registering. Cash, checks, Visa and Mastercard are accepted.   ($15.00 NSF fee.)                                                                                                                                                                                                                                 

    2.     Student will be required to make up any absences in the next session.    

     REQUIREMENTS TO PASSING THE COURSE                                                                                                                                                                                           

    1.     Students must complete all homework and receive an overall grade of 75% on daily quizzes/test.                                                                                                                                                                                                                          

    2.     Students must pass the State Exam with 75% or higher.  Student will be given up to 2 additional attempts to pass the test.    

                                                                                                                                                                                                                            

    REFUND POLICY           

      If for any reason you decide to withdraw from the course, your refund will be based on the following: *  Before the class has started, 100% of the total tuition is refunded.


    PARTICIPANT/PARENT SIGNATURES     

    Date:                                      Student Signature:                                                                                         

    Date:                                      Parent/Legal Guardian Signature:                                                                  

    Date:                                      Right of Way LLC dba Right of Way Driving School   

    Provider name 

     By:                                                                Owner                                                         

           Signature of Provider Owner                       Title