JACK’S DRIVING SCHOOL
Classrooms at: 7588 Central Parke Blvd., Mason, OH 45040 and Mason Community Ctr. (513) 398-1999
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Student Legal Name
_____________
DOB
_______________
License #
___________________
Permit Date
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Address
City/State
Zip
County
High School
Home Phone: ___________________________
Current Driving Experience __________ Hours
Cell Phones: Students: __________________________
Parents: ____________________________
Jacks Driving School shall furnish a licensed instructor, a car equipped with dual brake control in safe operating condition, and meeting Ohio
insurance requirements. The Driver Education course will consist of 24 hours of classroom instruction, up to 30 minutes of additional time for a final
examination, and 8 hours of behind the wheel driving instruction based upon the Ohio Driver Training Curriculum. Classroom instruction will be at
our office location or the Mason Community Center during the public school year. Practical driving instruction will be in Warren County and the
surrounding counties area.
Charges:
The cost of the complete program shall be: Full payment @ 1st class $440.00 OR use of this Payment Plan: $150 @ 1st class, $150 payment by the
students 5th class, and $140 @ the 8th class. Behind-the-Wheel (In-Car) sessions will be scheduled when full payment has been received AND *
directions from the classroom, to the students home have been written on the students training folder. The use of a school owned vehicle to take the
drivers exam shall be $60.00 or pickup & return is $60/hr. If a student cancels a driving session less than 72 hours in advance, the charge is $25.00
unless we can find a substitute student. Students at fault in vehicle collisions are responsible for the deductible expenses.
Payment Record:
Date:
Amount $ _____________
_____________
_____________
Additional Comments:
(*) Students outside the 45040 or 45034 zip code do not need directions BUT will start and finish In-Car driving sessions from our
CMC Office location, and need to be ready 10 minutes prior to the scheduled drive time.
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Jacks Driving School will provide the complete course within 60 days.
Students will be dropped on day one-hundred and eighty days (180) from Jacks Driving School without receiving any refund, if they have
not completed the entire Drivers Education Course (as described above).
Disruptive behavior and/or destruction to school property will result in dismissal from the program, responsibility for replacement expenses
and no refund.
The driving school does not guarantee the issuance of a driver’s license to the student. Commercial driving schools are licensed by the
Department of Public Safety through the Driver Training Program Office, 1970 West Broad Street, Columbus, Ohio, 43223.
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Student
Date
Instructor #
Date
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Parent/Guardian
Date
State of Ohio regulations require the Driving
School to make available all by ____________