PENN-TRAFFORD 2017 SUMMER ACADEMY Behind The Wheel ...
PENN-TRAFFORD 2017 SUMMER ACADEMY Behind The Wheel Instruction (6 TOTAL HOURS)
Behind The Wheel instruction is actual driving by the student with a PA certified instructor. It is highly recommended that student complete the Driver’s Theory course prior to participating in Behind the Wheel. The student is required to have a valid PA Drivers Learning Permit or PA Drivers License. Instruction will be offered June, July and Aug. This service is available to Penn-Trafford student residents only; however, availability is on a first come, first serve basis. Please note, depending on the number of students registering, we cannot guarantee that everyone will receive instruction this year. If interested in registering for Behind The Wheel, please complete this form and an enrollment form. Submit forms to the high school main office by May 17. Checks should be made payable to: PennTrafford Summer Academy. Cost is $45.00. If approved, you will receive a call from the driving instructor to schedule your driving dates and time. Please submit this form along with the Course Enrollment form. NAME__________________________________________________________________________ DATE OF BIRTH_____/______/______
AGE ____________ CURRENT GRADE: (circle one)
10
11
12
HOME ADDRESS _______________________________________________________________________________ HOME PHONE ________________________________ STUDENT’S CELL PHONE _______________________ PARENT’S CELL PHONE ______________________ PARENT’S EMAIL: ______________________________ PLEASE ANSWER FOLLOWING QUESTIONS: 1.
DID YOU TAKE THE DRIVER’S THEORY CLASS YET?
YES _______
NO ________
2.
IF YES, PLEASE LIST THE DATE YOU COMPLETED THE CLASS____________________________ WHO WAS YOUR TEACHER FOR THEORY________________________________________________
3.
IF NO, ARE YOU SCHEDULED TO TAKE THE THEORY CLASS THIS SUMMER AND WHEN? YES ________ NO________ WHEN ___________________________________________
4.
I CURRENTLY HAVE: ________ DRIVER’S LICENSE ________ DRIVER’S PERMIT - DATE RECEIVED _______________
5.
SPECIFIC DATES I AM NOT AVAILABLE __________________________________________________ ________________________________________________________________________________________
IF YOU SIGNED UP FOR BTW AND DECIDE NOT TO PARTICIPATE, PLEASE CALL PTHS 724-744-4471 AS SOON AS POSSIBLE. THANK YOU!
Behind The Wheel instruction is actual driving by the student with a PA certified instructor. It is highly recommended that student complete the Driver’s Theory course prior to participating in Behind the Wheel. The student is required to have a valid PA Drivers Learning Permit or PA Drivers License. Instruction will be offered June, July and Aug. This service is available to Penn-Trafford student residents only; however, availability is on a first come, first serve basis. Please note, depending on the number of students registering, we cannot guarantee that everyone will receive instruction this year. If interested in registering for Behind The Wheel, please complete this form and an enrollment form. Submit forms to the high school main office by May 17. Checks should be made payable to: PennTrafford Summer Academy. Cost is $45.00. If approved, you will receive a call from the driving instructor to schedule your driving dates and time. Please submit this form along with the Course Enrollment form. NAME__________________________________________________________________________ DATE OF BIRTH_____/______/______
AGE ____________ CURRENT GRADE: (circle one)
10
11
12
HOME ADDRESS _______________________________________________________________________________ HOME PHONE ________________________________ STUDENT’S CELL PHONE _______________________ PARENT’S CELL PHONE ______________________ PARENT’S EMAIL: ______________________________ PLEASE ANSWER FOLLOWING QUESTIONS: 1.
DID YOU TAKE THE DRIVER’S THEORY CLASS YET?
YES _______
NO ________
2.
IF YES, PLEASE LIST THE DATE YOU COMPLETED THE CLASS____________________________ WHO WAS YOUR TEACHER FOR THEORY________________________________________________
3.
IF NO, ARE YOU SCHEDULED TO TAKE THE THEORY CLASS THIS SUMMER AND WHEN? YES ________ NO________ WHEN ___________________________________________
4.
I CURRENTLY HAVE: ________ DRIVER’S LICENSE ________ DRIVER’S PERMIT - DATE RECEIVED _______________
5.
SPECIFIC DATES I AM NOT AVAILABLE __________________________________________________ ________________________________________________________________________________________
IF YOU SIGNED UP FOR BTW AND DECIDE NOT TO PARTICIPATE, PLEASE CALL PTHS 724-744-4471 AS SOON AS POSSIBLE. THANK YOU!
