DT STUDENT CONTRACT Driver Training Student Contract Driver Training Student Contract Name * Name First First Last Last Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Phone Number * Emergency Phone Number * Birthdate * Amount Paid * Permit/License No * Permit/License Expiration Date * Location of Instruction * Dates & Times of Instruction Date Time 121234567891011 : 0030 AMPM Date Time 121234567891011 : 0030 AMPM Date Time 121234567891011 : 0030 AMPM Type of Instruction * 30 Classroom Only - Hours of instruction:30 Classroom Only - Hours of instruction: 30/6 Behind the Wheel Only - Hours of instruction:Behind the Wheel Only - Hours of instruction: I, the undersigned student, agree to complete the above course of instruction for a fee of $________, consisting of ______ hours of classroom instruction and ______ hours of behind-the-wheel instruction by the above-named Driver Training School. If additional behind-the-wheel instruction is requested, a fee of $________ per hour is charged. A charge of $________ will be assessed for the use of the school’s vehicle or for picking up a student or taking the student to the desired destination upon completion of a lesson. It is understood that this driver training school is certified by the Georgia Department of Driver Services (DDS) in accordance with Georgia Law Title §43-13-1 (The Driver Training School and Commercial Driving Training School License Act) and that each instructor is certified by the Georgia Department of Driver Services.The student’s successful completion of the above-named course requires each of the following:1. Punctual attendance for all sessions.2. Reasonable attentiveness and participation in all classes.3. Makeup classes for missed sessions.4. Successfully passing a written examination with a grade of at least 70.This driver training school will not refund any tuition or part of tuition if the School is ready, willing, and able to fulfill its part of this contract. I understand that if I fail to comply with the terms and conditions of this agreement, I am in breach of contract and the school will not be under any obligation to fulfill the terms of this contract, and may, at its option, terminate this agreement immediately.It is agreed that an owner, instructor, or employee of this driver training school shall not give the impression directly or implied to a student that upon completion of the course the student will receive a license to operate a motor vehicle. However, immediately upon the student’s successful completion of the course as described above, the driver training school agrees to provide certification of said completion to the student.This driver training school has and will maintain for the protection of the contractual rights of the student a performance bond in the principal sum of ten thousand ($10,000.00) dollars for the students to be written by a company authorized to do business in the State of Georgia.This agreement constitutes the contract between the above-named driver training school and the above-named student and no verbal statements will be recognized. * Signature of Student * Clear Signature of Parent or Guardian * Clear Date Date If you are human, leave this field blank. Submit
