Are you a driver at Stepinac High School? If you are, then the Stepinac Drivers Form is a great way to help ensure that everyone on campus gets where they need to go safely. This form was designed with student and staff safety as its primary goal, in order to make sure that everyone can get around campus without any issues. It's an important part of life here at Stepinac, so if you're looking for more info about how it works, just keep reading below!
| Question | Answer |
|---|---|
| Form Name | Stepinac Drivers Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | stepinac drivers ed spring 2020, 2011, 1st, stepinac drivers ed |
Driver Education
Offered at Archbishop Stepinac High
950 Mamaroneck Ave., White Plains, NY 10605
Fall Program |
OPEN TO |
|
|
||
Great Choices! |
SCARSDALE |
|
HIGH |
||
Saturday Driving & Lecture or |
||
SCHOOL |
||
|
||
Weekday |
STUDENTS |
|
|
Insurance Discount*
Senior License at 17
Become a Safe Driver
N.Y.S. Approved Program
*check with your insurance company
Orientation for the Fall Program: September 27, 2011
at 3:00pm in the Cafeteria
Student Must Be At Least 16 Years Old By October 1, 2011
Early Registration Means Best Choice of Times
Application Available on Archbishop Stepinac Website
ARCHBISHOP STEPINAC HIGH SCHOOL DRIVER EDUCATION PROGRAM
APPLICATION/CONSENT SLIP
950 Mamaroneck Avenue, White Plains, NY 10605 (914)
Today’s Date:________________
Student’s Name, Address, Date of Birth and Permit/License # MUST BE EXACTLY as on
the permit/ license otherwise the DMV will NOT Convert
|
|
|
|
Male ( ) |
Female ( ) |
__________________________________________________________ |
___________________________ |
||||
Last |
First |
Middle |
Date of Birth |
||
__________________________________________________________ |
_____________ / _______________ |
||||
Number |
Street |
|
Home Phone |
Student Cell Phone |
|
__________________________________________________________ |
___________________________ |
||||
City |
State |
Zip Code |
|||
|
|
||||
|
PERMIT/LICENSE NUMBER |
: _____________________________ |
________________________________ |
||
|
|
(Required by October 1, 2011) |
Name of |
||
The program consists of 90 minutes of driving and 90 minutes of lecture class each week for 16 weeks.
Driving Time: Please indicate your top 3 driving preference days by placing a 1, 2 & 3 in the boxes below. Next to the number, indicate the earliest time you can start driving. Please be aware that student registration priority and teacher availability may limit some choices.
( |
) |
Monday ____________ |
( |
) |
Tuesday ____________ |
( |
) |
Wednesday __________ |
( |
) |
Thursday ___________ |
( |
) |
Friday ____________ |
( |
) |
Saturday __________ |
Lecture Class: You will be assigned to a class (day/time determined by space and teacher availability).
PARENT/GUARDIAN INFORMATION AND CONSENT
I give my child permission to be enrolled in the aforementioned driver education program.
___________________________ |
___________________________ |
____________________ |
||
Parent/Guardian (Print Name) |
|
Parent/Guardian (Signature) |
|
Cell Phone # |
EMERGENCY CONTACT INFO: |
__________________________ |
____________________ |
||
|
|
Name |
Phone # |
|
IMPORTANT INFORMATION
1)A permit is required by October 1st , 2011.
2)The fall program starts October 1st and will be conducted for 16 weeks.
3)Fee for the program is $525. Please make check payable to Archbishop Stepinac High School and mail it with the completed/signed application by a parent or guardian to Archbishop Stepinac H.S. Driver Education Program, 950 Mamaroneck Avenue, White Plains, NY 10605
4)Payment is required with this application. After 2 weeks, all refunds for the program will be prorated.
5)Course requirements, driving and lecture time assignments will be provided at the mandatory
Orientation on September 27th at 3:00pm in the Cafeteria.
6)Driving instruction is provided by PAS Auto School (914)
DO NOT WRITE BELOW THIS LINE. FOR OFFICE USE ONLY.
ASSIGNED DRIVING TIMES |
___________ |
|
______________ |
_______________ |
||
|
|
Day |
|
Time |
Teacher |
|
ASSIGNED LECTURE TIMES |
____________ |
|
______________ |
_______________ |
||
|
|
Day |
|
Time |
Teacher |
|
PAYMENT ______________ |
CHECK # |
____________ |
DATE _______________ |
|||
PR___ |
DA___ |
PU___ |
PA___ |
|
|
|
|
|
|||||