Precision Driver Training School - Application
Please print clearly.
Legal Name: last:_______________________first:_______________________middle I_____
Permit # _________________________________ Date of Birth:_______/________/________
Age as of course ending date:_________ Your Phone # _______________________________
Person for Emergency Contact _____________________________ Phone _______________
List current medications:________________________________________________________
List any substances known to cause allergic reactions:________________________________
List relevant physical/medical conditions:___________________________________________
List relevant learning challenges:_________________________________________________
Other than above, I certify that I have no conditions that may place myself or others at risk of injury.
Please circle the location you plan to attend. . . . Course beginning date:_________________
Morrisville - Barre - Irasburg - Winooski - Essex - Newport - Other:__________________
Please snail mail to:
Precision Driver Training School
900 Rt. 58 W
Irasburg, VT 05845
Refund Policy: The $200 deposit is not refundable. The balance of the tuition may be refunded to students who pay the full amount of tuition prior to the first class and choose to withdraw on or prior to the first class. Refunds will not be issued after the second day of class.