Registration

Complete this form to register. Click on 'Submit' when ready to send.
When we receive your registration, we will US Mail you a packet of information, which includes an information sheet, the Nelson Driving School policies and an Instruction Permit Application. Payment is due at the first class session and is not needed for registration.

STUDENT INFORMATION

Last Name:     First Name:

Middle Initial:

Date of Birth:

Address:

City:      State: Zip:

Home Phone:       Cell Phone:

Gender: Male Female

E-mail Address:

High School:

Do you have an Instruction Permit?
Yes
No

PARENT INFORMATION

Parent / Guardian:

Phone:

E-mail Address:

Sign me up for this schedule:

Comments / Questions: