Registration Form for 36/38 Hour Courses

36 hour course fee ..... $395.00

38 hour course fee ..... $495.00 (1/1/09)



***** NOTE: Effective September 1, 2004, you must maintain a Learner's License for 180 days before applying for the Intermediate License, provided you have not yet reached the age of seventeen. *****

     (Click here to print this form, fill it out, and mail it with your $50.00 deposit)

 

 

Name: _________________________________________________________ 
(as on birth certificate)

Address: _____________________________________________   DOB: ________________

City: ______________________________________  Zip: __________________ 

Home Phone: ___________________________  Cell Phone: _____________________________

Session#: _______________

 



Mail this form and $50.00 deposit to:
Stop N Go Driving Academy     9343 Florida Blvd., Suite C    Baton Rouge, LA. 70815

 

 

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