ALLEGANY DRIVING SCHOOL
Name
First Name
Middle Initial
Last Name
DOB
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone
Format: (000) 000-0000.
Phone 2
Format: (000) 000-0000.
Driving Experience
Permit Yes
Permit No
Health Issues (Driving Related)
Terms and Conditions Acknowledgements: Click each box to agree to terms and conditions.
** I am aware that all class time and driving time is required prior to successful completion.
** I am aware that I must give 12 hours notice if a scheduled driving appointment must be canceled. A $50 penalty must be paid from the student to the in car instructor if proper notice is not given.
** There is a 1 year time limit on the completion of the entire driver education program. Failure to complete in 1 year will result in a grade of incomplete and the student will have to restart the program in order to continue.
** Refunds will not be offered after 1 year of program start date.
** I am aware of the risks involved with learning to drive and give permission to the driving school to train and educate this student in accordance with the MD Standardized Curriculum.
** Due to a delay in the driving portion of the program during the COVID 19 State of Emergency, there may be a slight delay in the scheduling and completion of driving appointments. We will do our best to attend to the desires of those individuals that are closest to testing for provisional license first. Please be patient. Our staff is working hard to address our behind the wheel student volume.
Parent Signature
Student Signature
Students will be contacted by phone or in class regarding driving appointments. Please inform the classroom instructor of special concerns related to vacation, permit expiration, and in car instructor requests.
Questions regarding these policies and other driver education issues may be directed to our office at 301-766-0087.
Back
Next
Unit 1: Getting Acquainted with Your Driving School and MVA New Drivers Guidelines
With Every Right Comes a ResponsibilityThe Student and the Driving School
Each student has the right to a certified competent instructor, knowledgeable about the curriculum and traffic safety issues. With that right each student has the responsibility to arrive prepared and on time for every class without such distractions as talking or text messaging on cell phones, being disrespectful to the instructor, or talking with other students in class.
Each student has the right to be taught the entire 30 hours of classroom instruction in an informative, interesting and challenging manner. With that right each student has the responsibility to be attentive and actively participate in every class.
Each student has the right to experience the full 6 hours of behind-the-wheel driving instruction as required in the curriculum. With that right each student will listen to the instructor and not drive in a negligent or dangerous manner.
Each student has the right to be treated in a courteous, civil and respectful manner. With that right students have the responsibility to be polite and respectful to their instructors at all times, and be willing to accept positive criticism to help them achieve driving success.
Each student has the right to attend class in a clean, safe, secure, temperature-controlled and fully-equipped classroom that meets the local fire and building codes and MVA requirements. With that right each student has the responsibility to respect the property of the driving school by not defacing or destroying equipment or vehicles.
Each student and parent/driver coach has the right to visit the driving school, see the instructor's license and certification, and the right to observe any class session including in-car sessions, in which their child is included. With that right each parent/driver coach has the responsibility to refrain from interfering with the instruction, classroom or driving, while the class is in session.
Each parent/driver coach and student has the right to have the driver education program, including both the 30 hours of classroom instruction and the 6 hours of required driving time, completed within 18 weeks of the first day of class. With that right each parent/driver coach has the responsibility to take an active role in his/her student's driver education by monitoring all progress, communicating with the driving school and/or instructor, and practicing with the student driver if he/she has a learner's permit.
Each parent/driver coach and student has the right to place a complaint with the Motor Vehicle Administration regarding problems associated with the driving school or the instructor (the number to call is 410-424-3751). With that right each parent/driver coach and student has the responsibility to attempt to promptly pay the driving school for the driver education class and to attempt to alert the owner or manager of the driving school about any problems or complaints before contacting an outside agency.
I understand the rights and responsibilities of Driving Schools, Students, and Parent/Driver Coach
Date
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Back
Next
EMAIL ADDRESS
example@example.com
Are you Hispanic or Latino?
Yes
No
ETHNICITY (Please check all that apply):
White
Asian
Native Hawaiian / Other Pacific Islander
Black / African American
American Indian / Alaska Native
BIRTHDATE
-
Month
-
Day
Year
Date Picker Icon
Gender
Male
Female
Class Start Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Class Time
I certify that the information on this form is correct. Must be signed and dated to be official. By signing this form, I agree to abide by the policies and procedures of the College, including without limitation, the Student Code of Conduct.
Preview PDF
Submit
Should be Empty: