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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 2023
38 Teen Driver Classes 2023
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April 23,24,29,30 2023
June 2,3,4,5
June 23,24,25,26
July 7,8,14,15
July 21,22,23,24
September
October
November
Name of Student (First/Middle/Last)
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Last Name
First Name
Middle Name
Date of Birth
*
-
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
*
example@example.com
Email -Student Email
example@example.com
Student Age
*
Student Phone Number
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Parent Phone Number
*
Home Number
High School Attending
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TIP issue Date
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Month
-
Day
Year
Located on permit
Cert#
Unit 1
Unit 2
Final Class Grade
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. Go to expresslane.org to schedule DMV appointment
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
*
Parent's/ Guardian's Driver License/ID Card #
*
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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Kajun Lanes Driving Academy
$
100.00
Kajun Lanes Driving Academy Teen Class Deposit is non-refundable.$105 (Deposit and Processing Fee)
Payment Processing Fee
$
Free
Payment Processing Fee
Subtotal
$
0.00
Shipping
$
0.00
Total
$
0.00
Submit
DRIVING SCHOOL INFORMATION
Should be Empty: