Teen Behind-the-Wheel Course Request
Complete the online application to begin enrollment for the behind-the-wheel course.
Select your behind-the-wheel session.
*
Please Select
July 10-July 19 - Afternoon
Select the days and times you are available for driving.
*
Rows
Monday
Tuesday
Wednesday
Thursday
Friday
9 am - 11 am
11 am - 1 pm
1 pm - 3 pm
3 pm - 6 pm
Student Information
Student Name
*
First Name
Last Name
Birth Date
*
/
Month
/
Day
Year
Date Picker Icon
Today's Date
/
Month
/
Day
Year
Date Picker Icon
Student Age
Gender
*
Student Phone
*
Best number for updates and arrival notices.
Format: (000) 000-0000.
Student Email
*
Confirmation Email
Best email for updates and documents.
School Currently Attending
*
Input "N/A" if you do not attend school.
School Dismissal & Home Arrival Time
*
Input "N/A" if you do not attend school.
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your pickup address the same as your home address?
*
Please Select
Yes
No
Pickup Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Upload the front of your Virginia learner's permit.
*
Browse Files
Drag and drop files here
Choose a file
All information must be legible and visible.
Cancel
of
Did you hold a learner's permit in another state?
*
Please Select
Yes
No
Upload the front of your out-of-state learner's permit.
*
Browse Files
Drag and drop files here
Choose a file
All information must be legible and visible.
Cancel
of
Do you have a Virginia Driver Education certificate?
*
Yes. I completed the course at my high school or at another driving school.
Yes. I completed the course at Top Notch Driving School.
I am currently taking the online course at Top Notch Driving School.
No. I completed the course out-of-state. (The certificate must be reviewed and approved by the DMV)
Upload your Driver Education Course certificate
*
Browse Files
Drag and drop files here
Choose a file
The original certificate must be given to the instructor when classes begin.
Cancel
of
How many hours of driving practice do you have?
*
I will complete the 45 hours of practice before the course begins.
I have completed 45 hours of practice with at least 15 of those hours after sunset.
Select where you have practiced.
*
Perpendicular Parking Lot
Residential Streets
City Streets
Interstate
2-Lane Highway (one lane in each direction)
4-Lane Highway (two lanes in each direction)
Bridge
Tunnel
Select where you have practiced and for how long.
*
Rows
None
1 hour
2-4 hours
5-6 hours
7-8 hours
9-10 hours
11+ hours
Parking Lot
Residential Streets
City Streets
2-Lane Highway
4-Lane Highway
Interstate
Bridge
Do you have any physical or learning disabilities?
*
Please Select
Yes
No
If Yes, please describe any information the driving instructor should know.
*
If you have any questions or additional information, leave them below.
Parent/Guardian Information
Parent/Guardian Name
*
First and Last Name
Relationship to Student
*
Mother
Father
Other
Parent/Guardian Phone
*
Best number for updates or an emergency.
Format: (000) 000-0000.
Parent/Guardian Email
*
Confirmation Email
Best email for updates and documents.
How Did You Hear About Us Survey
How did you discover Top Notch Driving Schools Inc.?
*
DMV (website, handout, etc.)
Google search
Yelp search
Social media
Business card or brochure
Recommended by a friend or colleague
Returning customer
Other
Submit
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