Spring Term 2017 Driver Education Registration Form
(*revised 10/12/16)
Legal Name:____________________________________________________________________________________________
(print) Last
First
M.I.
Address:______________________________________Town___________________Zip____________________________
School attended during regular year_______________________________________M_______F______
Parents telephone number(s)________________________________________________________________________
Student birthdate_________________Student DMV 9 Digit ID#________________________________________
Parental Consent: I certify that I am parent or legal guardian
of__________________________________________________________and hereby grant him/her
permission to enroll in the Saint Anthony’s High School Driver Education.
Date______________________Parent’s Signature__________________________________
* Driving and lecture are approx.. 1.5 hours each. If you do not have a permit yet you
may still register. The permit must be obtained by Feb 1st. Please send a copy A.S.A.P.
1st Choice (circle one session and time)
2nd Choice (circle one session and time)
Mon Tues
Mon Tues Wed Fri
Wed
Fri
Sat
Sat
Weekday Start Times 2:30pm 4:00pm
Weekday Start Times 2:30pm 4:00pm
Saturday Start Times ONLY
7:00am 8:30am 10:00am
Saturday Start Times ONLY
7:00am 8:30am 10:00am
Tape/ staple copy of permit here
Cut permit/license copy to fit in this space,
Thank you.
Make all checks payable to:
Saint Anthony’s High School
Mail to:
St. Anthony’s High School
Driver Education
275 Wolf Hill Road
S. Huntington NY 11747-1394
This course will run from
February 6th – June 10th
1. After checking the session days choose a session
and a start time for 1st and 2nd choice.
2. Send in a completed registration form with a $210
deposit. Total tuition is $610. Text is an additional
$25. Balance ($400) is due on the first day.
Balance and text may be paid with one check
3. The application may be sent in without a permit.
A valid NYS permit/license must be obtained by
February 1st to be eligible for the spring semester.
Send in a copy A.S.A.P. if it is not included with the
registration form.
4. Applications are processed on a first come first
served basis.
5. Students who wish to be scheduled with friends
MUST return completed applications in the same
envelope.
6. Saint Anthony’s Driver Education is open to all
public, private and parochial high school students.
7. Please call 631-421-9190 or email
[email protected] if you have any
questions.
8. There will be no regularly scheduled driver
education for Thursdays. Thursdays will be used
as a make up day.