BOX ELDER HIGH SCHOOL REGISTRATION FORM FOR DRIVER

BOX ELDER HIGH SCHOOL REGISTRATION FORM FOR DRIVER EDUCATION: Spring(3rd) TRIMESTER 2015 Please Print: Student’s Name:_____________________ EMAIL: ___________________________

Date of Birth:_________________________ Phone: _________________________

Students must be 15 by March 1, 2015 to register for spring trimester. Three (3) sessions will be offered. Please check the dates and time for each session and make sure that you can be there each day. State Law requires 30 hours of classroom instruction. MAKE UP is very difficult. Students not completing the thirty hours of class instruction will fail the class. NO EXCEPTIONS.Along with the class, students will be required to drive 6 hours on the road and observe for 6 hours in the Driver Education car. These sessions will be scheduled individually with the students. The registration fee for Driver Education is $195. This is collected on the 2ndday of class. PLEASE CHECK ONLY ONE SESSION [ ] 1.

Mar. 16 – Apr. 27

Time: 3 pm to 6 pm

J-2

BEHS

[ ] 2.

Mar. 17 –Apr. 28

Time: 3 pm to 6 pm

A-2

BEHS

[ ] 3.

Mar. 21 – May 23

Time: 7 am to 10:20am

P-4

BEHS

[ ] 4.

Electronic High School Version ---- Register online at http://www.behs.besd.net/driversed/driversed.htm

4. March 31 - Optional Parent/Teen nightTime: 6 pm to 8 pm *See Attached Flyer for information about Parent/Teen night

BEHS Auditorium

This top portion of this form must be returned in order for the student to be registered. Please return to Mr. Burt in room A-2, or the main office at Box Elder Middle/High School as soon as possible. Classes are filled on a “firstcome, first- served” basis. Once a class is full, it is full. If the registration form is turned in, then the student is registered unless notified by the instructor. Parent Signature __________________________ Student Signature ___________________________ ____________________________________________________________ (Detach bottom portion and keep for your records) Your student is registered to take Driver Education at Box Elder High during this year’s spring trimester. PLEASE CHECK ONLY ONE SESSION [ ] 1.

Mar.16 – April 27 Time: 3 pm to 6 pm J-2 BEHS This class will be held on Mondays and Wednesdays. The dates for all the class sessions are: Mar. 16, 18, 23, 25, 30, Apr. 1, 13, 15, 22, 27* (No Classes held on April 6, 8, or 20)

[ ] 2.

Mar. 17 – April 28 Time: 3 pm to 6 pm A-2 BEHS This class will be held on Tuesdays and Thurdays. The dates for all the class sessions are:Mar. 17, 24, 26, 31, Apr. 2, 14, 16, 21, 23, 28* (No classes held on Mar. 19, April 7 and 9)

[ ] 3.

Mar. 21 – May 23 Time: 7 am to 10:20 am P-4 BEHS This class will be held on SATURDAYS. The dates for all the class sessions are: Mar. 21, 28, Apr. 4, 18, 23, May 2, 9, 16, 23. (No class held on April 11)

QUESTIONS: Visit http://www.behs.besd.net/driversed/driversed.htm or contact us directly. Mr. Peter Burt435-279-0121 (class 2) Mr. Gregg Cefalo435-279-3218 (class 3)

Mr. Donny Constantineau 435-279-7920 (class 1) Mr. Tom Davidson435-740-4108(Electronic Class)

The student is expected to be ready to work, with paper and pencil on the first day of class. The textbook and the Utah Driver Handbook will be provided. The cost of the program is $195 ($55 for the classroom and $140 for Road Instruction). Fee-waivers do apply. This is to be paid on the second day of class, if possible. Please make checks payable to BEHS.