PRIVATE LESSON REGISTRATION

2800 W Broad St #611, Athens GA 30606

BY APPOINTMENT ONLY

elly@athensdrivingprep.com

www.athensdrivingprep.com

(706) 850-2800

LIC# LDT-710
REGISTRATION IS NOW OPEN FOR SUMMER LESSONS
PRIVATE LESSON REGISTRATION

No money is due when you register. You do not pay until we have found you a place on the schedule.
- Legal Name (as it appears on your permit/ license)
  
  First NameMiddle NameLast Name
- Preferred name to be called
- Student Email
- Phone Number
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  City and Zip CodeState / Province
  
  Postal / Zip Code
- School currently attending (if any); this helps us with scheduling
- Please provide a clear and legible snapshot of the entire front of your permit/ license:
- Birth Date
  
  MonthDayYear
- Permit/ license Number
  e.g. 11183021
- Permit/ license issue date
  
  MonthDayYear
- Permit/ license expiration date
  
  MonthDayYear
- Parent Name
- Parent email
- Parent phone
  Format: (000) 000-0000.
- Emergency Contact (additional/ different from above)
  
  NamePhone #
- I am interested in:
- Not sure about which package you need? You can always start with a basic six-hour package and add single or multiple lessons later on as needed. Click here for lesson package descriptions.
- Check the ones which best describe your driving experience so far:
- Have you completed a 30-hour Joshua’s Law driver education course (not ADAP)?
- Do you have the means to practice between lessons?
- Anything else?
- How did you hear about Athens Driving Prep?
- Should be Empty:

REGISTRATION IS NOW OPEN FOR SUMMER LESSONS

PRIVATE LESSON REGISTRATION