Calvary
Christian School
Driver Education Program
145
Hampstead Road
Derry, NH 03038
(603) 434 -1501
www.ccsderry.org
Driver Education Rules /
Permission Form
- Full payment of the class is $550.00 +
$25.00 Gas Surcharge. A
deposit of $150.00 is paid in advance and a balance of $425.00
is paid at the time of the first class. Students will be
registered only upon receipt of completed forms, copy of birth
certificate and deposit.
- Please be prompt to classes. Students are
not allowed to miss more than a total of 4 hours of class for
any reason. Any amount of absence over 4 hours will result
in an incomplete or failing grade for this course. There
will be no exceptions, as this is a state
regulation.
- Students will be able to do the following:
- Recognize and obey stop and yield
signs
- Track straight down the road and in
turns
- Back straight within a foot of the
curb
- Back into a perpendicular parking
space between two cars
- Drive within posted speed limits
- Park in perpendicular parking spaces
(left and right side), and parallel parking space
- Comply with right of way laws
- Turn around using drive ways and
3-point turn
- Students must return textbook in condition
it was given.
- Students’ parents/guardian must attend
first class.
- Students must attend 30 hours of class.
If a student is absent from class, then he/she must attend the
make-up class and/or do a project outside class. If a student
misses more than 2 class meetings he/she will fail driver
education and no refund will be granted.
- Students must achieve a grade of 80% to
pass the course.
- Students will receive information by means
of classroom instruction, videos, textbooks – state driving
manual, and guest speakers:
- Paramedic
- State Police
- No Zone – Tractor Trailer Co.
- Insurance Agent
- Students must complete 10 hours of driving
and 6 hours of observation in the driver education car. Driving
lessons are scheduled in advance. If a student misses driving
lessons without notification, then he/she will be required to
pay a missed driving lesson fee of $30.00 before re-scheduling
the missed lesson.
- Canceling of a driving lesson should be
done 24-hours prior to the scheduled lesson by a phone call to
the instructor. Changes may also be made during classes. You
will not be charged if you call.
- Students must be sixteen years of age by
the conclusion of the course.
- If school is cancelled due to bad weather
that does not mean that driving times or class will be
cancelled. Students will be notified by their instructor if
cancelled.
- No refund will be given after 7 class
meetings or 4 driving lessons are completed.
- No smoking on school property.
- No littering on school property.
- No swearing allowed. Violations of rules
14-16 will result in being withdrawn from the class with no
refund.
- Upon successful completion of the course,
all paperwork will be given to the student.
- All students must pass an eye test (20/40
is passing) at the first class.
- No student will be given a GREEN slip
(showing successful completion of drier education) if:
- Textbook is not returned or paid for
if lost - $50.00
- An 80% average is not achieved
Further information may be obtained by
contacting the instructors.
Mr. Ivan Melton –
Cell: (603) 548-7464 Work: (603) 434-1501
* Driving hours will
be scheduled between the instructor and student. Some Saturday’s
maybe necessary.
I have read,
understand and agree to abide by the driver education rules.
q
I am interested in the
____________(month)_____________________course.
q
I give permission for
________________________________________________ to participate in
driver education as offered by Calvary Christian School. To the
best of my knowledge, he/she has neither physical and/or mental
problems nor any other disabilities which would interfere with the
save operation of an automobile.
q
Are the driving privileges for the person enrolled in
the driver education program currently under suspension or
revocation? Yes ______ No ______
q
Is any pending action against the person enrolling in
this driver education program which could cause the driving
privileges to be suspended or revoked in the future? Yes
______ No ______
q
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
_______________________________________ Date ___________
Student’s Signature
_____________________________________ Date ___________
Address
______________________________________________________________
Home Phone ________________
Please mail or
deliver forms, copy of birth certificate and $150.00 deposit to:
ATTN: Driver
Education
Calvary
Christian School
145 Hampstead
Road
Derry, NH 03038
** Please print full legal name
Name
____________________________________________________________________
(First)
(Middle) (Last)
Address___________________________________________________________________
(Street)
(City) (State) (Zip)
Home Phone ____________________ Student Cell #
____________________
Date of Birth ___________________________ Age
_________________
Month/ Day / Year
School Attending
_____________________________________________________
Parent/Guardian Name ________________________ Work Phone
_____________
Mailing Address (if different)
___________________________________________
e-mail address
________________________________________________________
