Kajan Lanes Driving Academy Location: Hampton Inn Hotel 6896 Hwy 1 Mansura, La. 71350
La. Dept of Public Safety and Corrections 318-305-0599
38H Teen Driver Education Registration 2021
38 Teen Driver Classes 2021
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September 11,12,13,19 8a-4p
October 9,10,11,17 8a-4p
November 20,21,22,28 8a-4p
Name of Student (First/Middle/Last)
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Last Name
First Name
Middle Name
Date of Birth
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Month
-
Day
Year
Date
Address Must be Physical Address .. NO PO Box
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Street Address
City
State
Zip Code
Email- Parent Email
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example@example.com
Email -Student Email
example@example.com
Student Age
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Student Phone Number
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Format: (000) 000-0000.
Parent Phone Number
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Format: (000) 000-0000.
Home Number
Format: (000) 000-0000.
High School Attending
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TIP # (Temporary Instruction Permit Number)
TIP # Located on permit Students may register now, then go to DMV for Permit. Due to recent new state requirements, students are required to obtain a Temporary Instructional Permit prior (Before) beginning driver ed class. Each student will have to go with a parent or legal guardian to the DMV to obtain their temporary instructional permit (TIP) from the DMV/OMV. Items to Bring to the Office of Motor Vehicles to obtain a Temporary Instruction Permit for Driver’s Education: Student must have parent present at DMV along with the following: •Original or State Certified Birth Certificate (no photocopies) •Social Security Card •Original or Court Certified Custody Papers (if there are any) •Legal Custodial/Domiciliary Parent/Guardian with their Driver’s License or State ID Card Temporary Instruction Permit fee at DMV is $32.50
TIP issue Date
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Month
-
Day
Year
Located on permit
Unit 1
Unit 2
Final Class Grade
Final OMV Test
Grade Level
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Students Grade Level in School
Describe locations where you have driving experience. Check all that apply
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None
Subdivisions
Parking Lots
Rural Roads
Highway
Interstate
In town
None
Subdivison
Parking Lots
Rural Roads
In Town
Highway
Interstate
Notes
Cert Age
TIP # (Temporary Instruction Permit Number)
Each student MUST have a TIP in order to attend class... NO exceptions
Comments or Questions
Browse Files
Cancel
of
The below Louisiana Class D & E Driver's Guide can be view at KajunLanes.com
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Parental/ Guardian Consent
I do hereby certify that I am the ______________________(select from drop box) if the minor applying and this is my authorization to the above named Driving School to administer the driver education course indicated above.
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Legal Domiciliary Father
Legal Domiciliary Mother
Legal Guardian
Parent/Guardian Name
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Parent's/ Guardian's Driver License/ID Card #
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38 Hour Class fee is $350. Deposit of $100 must be paid upon submission of this registration in order to complete it. Deposits are non-refundable. Remaining balance of $250 is due on first day of class. 38 Hour Deposit $100
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Subtotal
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Shipping
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Total
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Submit
DRIVING SCHOOL INFORMATION
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