Mendys Driving School, LLC 1904 W. Pinhook Suite 102 Lafayette La.

70508

Registration Form FILL COMPLETELY AND NEATLY Todays Date: _________________________________________________________ Applicants Name ______________________________________________________ Applicants Birth Date: ___________________________ Age: __________________ Address: _____________________________________________________________ City: _____________________________ State___________ Zip: ________________ Home Phone: _______________________ Cell Phone: _________________________ SS Number: ____________________ Email: _________________________________ Applicants Birth Certificate #: ____________________________________________ Applicants State Issued ID #: ____________________________________________ ** If you are UNDER 18, Submit Parent/Guardians Information Below** ************************************************************************ Parents Printed Name: ___________________________________________________ Parents Drivers License #: _______________________________________________ Parents Cell phone/Home phone: __________________________________________ Parents Email: _________________________________________________________ ________ 38 HR Class (30 hr. class instruction/8 hr. driving) ________ 6 HR Class (6 hr. class instruction only)

THANK YOU FOR CHOOSING MENDYS DRIVING SCHOOL.

Mendys Driving School, LLC Course Guide 38 hour drivers license course (30 hours classroom instruction and 8 hours behind the wheel) Call 337-456-3276 for more information. Schedule: 38 hour classes will be held on weekends during the school year, over vacation holidays, and during summer break (If enough want to sign up for a week day time one can be arranged.) To enroll in class, student and parent (if under 18) must sign the enrollment for m and provide: 1. Students certified birth certificate or birth card (from vital records) and social security card 2. Parents drivers license (if under 18) or students state-issued identification card (if over 18) Once student has satisfactorily completed the classroom course with a minimum score of 80%, he/she will then be required to drive 8 hours behind the wheel. Students must schedule their time to drive and will be scheduled on a first come first serve basis. Students will be given a Commercial School Instruction Permit that must be signed by parent (if under 18) and returned to instructor. *If student must reschedule, there is a $25.00 fee* When all 38 hours of this course are complete, student can then go to the DMV to get their permit. Completing this course does not ensure a driving permit. Student must pass the test at the DMV. Fees MUST be paid prior to the class in the form of cash, check, or money order. **Once enrolled, there is a $50.00 canceling fee.** 38 hr. classroom and driving $____________________ 6 hr classroom $____________________ Date of Class: ______________

Fees are good for 180 days only. If all hours are not completed in that time, new fees are due. No student will be issued a certificate of completion if he/she has not met all the requirements for course completion. Certificates will be given upon completion of course: 1 original and 1 copy. Additional copies are available for $15.00. This school will adhere to all applicable federal, state, and local laws and shall not engage in any form of unlawful discrimination or other illegal activities. Any grievance not resolved by the school may be forwarded to the Department of Public Safety and Corrections, Office of Motor Vehicles, Attention: CDL and Commercial Driving Schools Unit, P. O. Box 64886, Baton Rouge, LA 70896.