318-445-3237

1612 Military Hwy,

Pineville, LA 71360

Parent Cell *

Parent E-mail Address *

Temporary Instruction Permit Number *

Physical Address *

Parent Name *

Date of Birth *

Student Full Name *

Temporary Instruction Permit Issue Date *

Student Cell *

High School Attending *

Emergency Contact *

Grade Level *

The registration and payment are two SEPARATE submission! Please be sure to do both or your registration WILL NOT be processed!

Choose a Class Date *

Registration for 38 Hour Course

Once the in-class time is done, 8 hours of drive time will be scheduled. (must be 15 to drive)
The class is $325.00 total. To reserve a spot a minimum of $125.00 must be paid during registration
If the registration process is not completed BEFORE the first day of class, the student will be considered absent and must reschedule their class date.
Legal Custodial/Domiciliary Parent/Guardian Driver's License or ID Card is required.
Legal Parent or Guardian must complete the enrollment forms and sign documents at the school.
You must bring a Louisiana Temporary Instruction Permit, Original Birth Certificate, and Original or Court Certified Custody Papers if they exist.

*The $125 deposit is non-refundable.

Registration​ for 38 Hour Course