HOW TO ENROLL… 1) Must be 15 years old by 1st day of class. Complete this form, (be sure to read & sign.)
2) Clip & Mail with $150 (or full tuition) to: Margo’s Safety 1, 16710 Smokey Pt. Blvd. #202, Arlington WA 98223
Or drop off at our office in Smokey Point -- See map. For confirmation, give us a call within a few days
Teen Driver’s Ed Enrollment: Margo’s Safety 1 Driving School Inc.
Please enroll me in: 16710 Smokey Pt. Blvd. - Arlington WA 98223
(360) 659-1311 Class Location:(circle)
_______/_______/_______ Smokey Pt. / MP Hi
(Class Start Date mm-dd-yy)
(last, first, middle)Student's full legal name Parents Name (please print)
_______________________________________________________________________________________________________
Street Address City County Zip
_________________________________ __________________________ ___________________________
Mailing Address Home Phone Parents Work Phone
____ M F ___/___/___ ________How did you find us? Sign__ Friends/Family___Other
Age Gender Birthdate School Web____ yellow Pages:Verizon___Qwest___ Plaidbook____
EMAIL:_____________________________
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Terms: Select a Package- ( )SuperPremium 6 drive $385 (recommended) ( ) Premium 5 drive+Zed simulation $365
6 student minimum-not avail. at M-P hi
>$150 dollar deposit must be paid with registration to hold place in class. (Sale coupons if applicable, must be submitted upon registration for credit)
>Balance of tuition due at first class. A $10 Finance charge is added to balances not paid on time.
>Full tuition includes 30 hours of classroom, and ___ hours of Behind-the Wheel, & up to 6 hours of observation. (hours depend on selected Package) If additional drive time is needed, it is available at a rate of $40 per hour.
> Rescheduling fee: $40 for drive appointments missed or canceled less than 48 hours in advance.
>No Refunds are given after the first week of class. If no classes were attended, tuition minus $25 administrative fee will be refunded. Classes attended will be charged at a rate of $25 each and $45 per drive done, in addition to above fee. Transfers: additional fees apply.
> ____ <Init. To receive a completion certificate, a parent must attend our parent meeting and student must:
1) Complete all class sessions, drives, & class work (with at least an 80% score) by the end of class. (For extreme circumstances we may allow up to 21 additional weeks (Then student must retake entire course & pay again)Attendance must begin by the 3rd class, a total of 3 classes may be missed, but all missed classes must be made up. Student will be dropped from class for exceeding 3 absences.
2) Pay tuition & all fees, (including $20 lost book, $40 rescheduling,$10 late payment-$25 fee for NSF Checks, $25 drive retest if failed) Full schedule of fees available on request.
3) Obey all rules and behave in a mature, responsible manner toward other students, adults and property. Irresponsible behavior is grounds for immediate expulsion (NO REFUND).
Students must bring pen and paper (no spiral notebooks) to every class
I have read, and understand all of the above terms. I realize that this is a school, and I am not simply purchasing a completion certificate--it is like a diploma. My student must meet all standards (within the above deadline), in addition to paying all fees. By signing this registration, I agree to abide by the terms and policies of Margo’s Safety 1 Driving School Inc., and to help my student meet the requirements of this course and of Washington's intermediate licensing laws (see below for details of law)*
______________________________________ _______________________________________
Parent or Legal Guardian Signature (required) Student Signature (required)
NOTE: If your student has any unique needs that may affect learning in car/classroom, telling us in advance will help us serve them.(Examples: Past accident history, learning difficulties, medications, etc.)