Behind The Wheel Registration
Student Name
*
First Name
Last Name
Student Date of Birth
*
-
Month
-
Day
Year
Date
Student Email
*
example@example.com
Student Phone Number
*
Please enter a valid phone number.
Where does student attend high school?
*
Does Student Have A Valid Ohio Temporary Permit
*
YES
NO
Other
Temporary Permit # (Number will start will 2 letters followed by 6 numbers)
*
Permit Issue Date
*
Permit Expiration Date
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent Name
*
First Name
Last Name
Parent Phone Number
*
Please enter a valid phone number.
Parent Email
*
example@example.com
Please tell us who referred you, or how you heard about The Driving Authority.
Has the student completed the required 24 Hours of classroom time, online or in-person class? Online class certificate is required to register.
*
YES
NO
Please upload your student's online class certificate of online completed classes, an online class certificate is required for registration. Please do not upload a picture of proof that classes completed. Only actual certificates will be accepted.
*
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If your student attends Southern Hills Career Technical Center and has a payment voucher please upload a PDF or image of the voucher here.
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Behind The Wheel Driving Lessons
State of Ohio Required 8 Hours of Behind The Wheel Training
$
510.00
Behind The Wheel Driving Lessons (SOUTHERN HILLS CARRER CENTER STUDENTS ONLY)
State of Ohio Required 8 Hours of Behind The Wheel Training
$
110.00
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Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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