ONLINE
TEEN-AGED APPLICATION AND AGREEMENT 
(make checks payable to) MAD-AREA DRIVING SCHOOL 
copy and paste this application into your email then send here jkapinus@madareadriving.com
after you've completed the for
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Click on the link at the bottom of the page
Send to




    913 Lorena Pkwy     
    Madison, WI 53713-3373
COOPERATIVE DRIVER TESTING PROGRAM (CDTP)
Knowledge Score: _____________
Signs Score:___________________

Appointments/Questions     (608) 345-9598 10:30am-6:30pm Mon.-Fri.         
please complete the following information
Instruction area    

Date and location of class requested ________________________________________________________________________

Parent Name: ___________________________ Date: __/__/___  Parent Phone #____________ Email: ____________________
Student Name: ______________________ Birth Date:  __/__/___  Student Phone #___________ Email: ____________________
Address:______________________________________ ______

I (we) hereby make application to MAD-AREA DRIVING SCHOOL.     
For  ____________ Session, beginning on ___/____/____  Contract No.______________  

[] $435.00 A complete course of driving instruction - 30 hours of Online Classroom Instruction, 6 hours observing in the car, and 6 hours of driving time, for a total 
of 12 hours of behind-the-wheel instruction.


 *
To meeet course requirements and to avoid an additional $40.00 fee, both classroom and behind the wheel must be completed within 9 months of online or traditional classroom start date.
NOTICE: DRIVING IS A HIGH RISK/ADULT ACTIVITY..
..Therefore any student who demonstrates a lack of maturity, or respect for the privelidge to drive, through continued disruption or misbehavior, will be dismissed from class.
-($55.00  for each additional hour of behind-the-wheel sessions are available upon request.)-

Due to the inconvenience to the other scheduled/paired students,  In addition to the above; 
-I also agree to pay $20.00 for each missed b-t-w appointment or cancellation not called in 48 hours in advance. We reserve the right to delay or reschedule service.

This agreement constitutes the entire contract between the driving school and the student, and no verbal statement of promises 
will be recognized.  The school will not refund any tuition or part of tuition if the school is ready, willing, and able to fulfill its part
of the agreement as stated .   Note: your return email address will act as verification of your electronic signature you may type in your electronic signature


_______________________________        
 Signature of Student                                                         

___________________________________     ______________________________________     
 Signature of Parent/Guardian                                  Signature of Driving School Representative 
  

CLICK HERE TO REGISTER FOR THE ONLINE COURSE