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Chico's Driving Center LLC

571 Mast Rd.Suite 5

Manchester, NH 03102

603-624-8268

         Print this form for Enrollment

The State of New Hampshire requiremment is that your son / daughter must be 16 years old by the conclusion of the Driver Education course.

Course Date 1st Choice________________2nd Choice________________

A deposit of $300.00, needs to be paid in advance with the return of the completed Enrollment form. The balance of $325.00 will be paid by the first class. ( a surcharge may be added due to fuel prices).  A $20.00 fee for returned checks.

Applications are accecpted on a first come, first serve basis and driving time availability.  Students will be registrated only upon receipt of a completed form, copy of birth certificate and deposit.

Print Full Legal Name    First, Middle, Last

Name_______________________________________DOB______________

Address______________________________________________________

Home phone________________Student Cell phone__________________

Parent / Guardian Names________________________________________

E-Mail Address_________________________________________________

Master Card __Visa__Americian Express___Discover___

Card #__________________________________Expiration Date_________

Card Billing Zip Code ___________ Security Code from Back ______-

Name as appears on card__________________________________

Signature____________________________________________________

By signing this, I authorized Chico's Driving Center LLC. to charge my Account $__________

Free Periods/ Study Halls, Lunch - Study periods:_____________________





                      Driver Education Rules / Permission Form

Full payment for the course is $625.00.  A deposit of $300.00 is to be paid with the return of the registration for and the balance of $325.00 is to be paid by the first class.  Applications are accecpted on a first-come first-serve basis and driving time availability. 

Course consists of 30 hours of classroom instructions, 10 hours behind the wheel instruction and 6 hours of observation time.

Students are not allowed to miss more than a total of 4 hours of class for any reason.  Your Fifth hour of absence will result in an incomplete.  There won't be any exceptions, as this is a State regulation.

Students must satisfactorily complete 10 hours of driving and 6 hours of observation.  Driving lessons are scheduled in advance.  If a student misses a driving time without a 24 hour notification, then the student will be required to pay a missed driving lesson fee of $45.00  You won't be charged if you call your instructor.

Students will be required to document 40 hours of driving, 10 of which must be at night, and submit it to the State

Students must be 16 by the conclusion of the course.

If a class is cancelled due to bad weather, students will be contacted and / or it will be announced.  If school is canceled, then driver education class and driving lessons are cancelled for the day unless you hear from the instructor.

Students must return all textbooks in the condition it was passed out in.

Students must pass 4 manual quizzes with a grade of 80% or better.

Students must pass a Final Exam.

Any and all acts of lack of Academic Integrity will result in immediate termination from the course. 

Students must pass an in car driving exam.




















                                      No Refund Policy

No refunds will be given after 2 class meetings or 1 driving lesson is completed.

There will be a $100.00 Office Fee if you cancel a course, unless you register into a later course. 

No Smoking outside in-front of the school.

No littering outside of school.

Physical and or Verbal abuse will result in immediate removable from class

Upon successful completion of the course, all paperwork will be given out or mailed to your home.

All students must pass an eye test ( 20/40 is passing both eyes, 20/30 one eye) by the first class.

Students must bring textbook, DMV manual, pen or pencil to each class.

No student will be given a green slip if: a) tuition is not paid in full, b)haven't returned textbooks, c) haven't completed all assigned classroom and homework assignments and turned in by the end of class, d) any money owed.

I have read, understood and agree to abide by the Driver Education Rules

I give permission for__________________________to take Driver Education as offered by Chico's Driving Center LLC.  To the best of my knowledge, he/ she has no physical / mental problems now and other disabilities which interfere with the safe operation of an automoble.

Are the driving privileges for the person enrolling in the driver education currently under suspension or revocation? ___Yes___No.

If the enrollee's driving privileges become suspended or revoked during the program, any such action will immediately be reported to the driver education program administrator.

Parent Signature_________________Student Signature_______________

Home phone___________________Address__________________________

Student's Cell phone __________________Student's E-Mail____________

 
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