TAKE FIVE STUDENTS Registration Form

TAKE FIVE STUDENTS Registration Form
Did you attend another driving school? NO PROBLEM, we can still assist you with the following:

Take Five Driving Academy current students:

6 Hours Behind the wheel $250.00

Additional Driving time will be $250.00 (Student will be driven for 2 hours Three times.)

Road Skills Test $85.00 We now offer a $10.00 Discount

Defensive Driving Course $75.00

Please upload your permit or school envelope below.

DO NOT BREAK THE SEAL ON YOUR ENVELOPE FROM THE PREVIOUS SCHOOL.

Has it been more than five years since you took your classroom portion? Unfortunately, you will have to retake the full class. Please register with us under the ENROLLMENT tab.
Full Name*

First NameLast Name
Previous Driving School Name:
Date of birth *

MonthDayYear
Date
Natchitoches Road Skills TestNatchitoches Behind The WheelNatchitoches Defensive Driving CourseNatchitoches OtherMany Road Skills TestMany Behind The WheelMany Defensive Driving CourseMany Other
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
1. Upload FRONT of TIP or Permit Card or License*

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2. Upload BACK of TIP or Permit Card or License*

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3. Upload Certificate of Completion envelope DO NOT OPEN. IF YOU HAVE A PERMIT RETAKE A PICTURE OF THE FRONT OF YOUR CARD

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By signing this form, I declare that all above information is true and correct. I understand that Road Skills Test is cash only and nonrefundable. *
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