Road Test Preparation

Road Test Preparation - Student Data

Fill out the form below to sign up for the Road Test Preparation course.
Student Information
Your Name*

First NameMiddle NameLast Name
Your E-mail*
This is the email we primarily correspond with including the schedule for approval
Phone Number*
Please provide student's contact number.Format: (000) 000-0000.
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list any medication, health or learning issues the student has that we should know about that would/could affect driving ability.
School Attending
Name of School
License Information
License Number*
Date of Birth*

MonthDayYear
Date
Issue Date*

MonthDayYear
Date
Expiration Date*

MonthDayYear
Date
Restrictions*
Driver's License - Front*

Cancelof
Testing Information
Emergency Contact
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Where was your last test completed?*
Location of Previous Road Test(s)?
Availability (PLEASE NOTE THIS IS NOT BOOKING YOUR APPOINTMENT)

Select your availability below. You can select multiple days/times if needed. We will email you our first available appointment based on your selection(s) for approval. Please respond to the email to confirm or make changes. *Time selected is not a guarantee.
Morning (9:00am - 11:00pm)Mid-Day (12:00pm - 2:00pm)Afternoon (3:00pm - 5:00pm)
Morning (9:00am - 11:00pm)Mid-Day (12:00pm - 2:00pm)Afternoon (3:00pm - 5:00pm)
Morning (9:00am - 11:00pm)Mid-Day (12:00pm - 2:00pm)Afternoon (3:00pm - 5:00pm)
Morning (9:00am - 11:00pm)Mid-Day (12:00pm - 2:00pm)Afternoon (3:00pm - 5:00pm)
Morning (9:00am - 11:00pm)Mid-Day (12:00pm - 2:00pm)Afternoon (3:00pm - 5:00pm)
Notes: (Please type any questions you may have below.)
I agree all information submitted in this form is accurate and true. I acknowledge transportation to/from Lakeland Atlantic Driving School is not provided. (LADS will provide the use of a testing car at the testing center.)
Select Your Road Test*
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Road Test Prep for 1st Road Test
$279.00



Road Test Prep for 2nd Road Test
$299.00



Road Test Prep for 3rd Road Test
$299.00



Road Test Prep Only
NO ROAD TEST INCLUDED

$200.00



Online Convenience Fee
$10.00



Total

$0.00
I further understand that all instructors and examiners speak English only. No translator can be used in any form. Failure to communicate could result in forfeiture of lessons and/or payment.
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty:

Road Test Preparation - Student Data

Student Information

License Information

Testing Information

Emergency Contact

Availability (PLEASE NOTE THIS IS NOT BOOKING YOUR APPOINTMENT)