Nichols Driving School (MA)

Please fill out the form below and we will get back to you as soon as possible.
Student Information
Full Legal Name (Exactly as it appears on your Massachusetts Learner's Permit)

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Permit Number
Permit Issue Date:

MonthDayYear
Date
Permit Expiration Date:

MonthDayYear
Date
Email Address:
example@example.com
Primary Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information (If student is under 18, needs translation,or assistance filling out the form)
Parent/Guardian Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Email Address
Road Test Services
Are you requesting a Road Test at the Nichols Driving School location?
- Springfield
- Greenfield
Would you like a 1-hour Road Test Preparation Lesson before your road test to go over what will be required to pass the road test?
Is your current permit/license status in good standing?
If NO, please explain why your right to operate a vehicle is suspended or revoked:
Driving Experience
Approximately how many hours of on-road driving experience do you have?
How often do you currently drive?
What types of roads have you driven on? (Check all that apply.)
Which driving maneuvers do you feel least confident performing? (Check all that apply.)
Previous Road Test History
Have you previously taken a Massachusetts RMV Road Test?
If YES, how many times?
If you previously took a road test, what was the outcome?
If you did not pass, please describe what happened or what feedback you received from the Road Test Examiner.
Have you previously trained with another driving school?
If YES, what was the name of the driving school? (We need the school name to tranfer you to our driving school through the RMV)
Road Test Scheduling
Do you currently have an RMV Road Test scheduled?
If YES, provide the following:
Road Test Date:

MonthDayYear
Time

Hour Minutes

AM/PM Option
RMV Branch Location:
If you DO NOT have a road test scheduled and would like Nichols Driving School to schedule one for you, what time frame are you hoping for?
Month
Year
Are your scheduling preferences:
Additional Information
Is there anything specific you would like our driving school to focus on before your road test?
Additional Comments or Questions
Acknowledgment

I certify that the information provided is accurate and complete. I understand that inaccurate permit information or missed appointments may affect my road test scheduling.
Name
Date

MonthDayYear
Do you want a 1-hour adult lesson before your scheduled road test date?
What is your on-road driving experience?
Have you had a road test before?
Have you gone through another driving school for any past road test? If so, what is the driving school name?
Do you currently have a road test scheduled?
Should be Empty:

Student Information

Parent/Guardian Information (If student is under 18, needs translation,or assistance filling out the form)

Road Test Services

Driving Experience

Previous Road Test History

Road Test Scheduling

Acknowledgment