Behind-The-Wheel ONLY - Available in 2-Hour Increments

Course Options*

2 Hours of Instruction$150.00

4 Hours of Instruction$300.00

6 Hours of Instruction $450.00

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

General Information
Parent/Guardian (if applicable)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Student Information
Driver's Name (must match permit/legal info)*

First NameLast Name
Birth Date*

MonthDayYear
School Name
Grade
Gender (must match permit/legal info)*

MaleFemale
Student Permit/License #*
If they don't have permit yet type N/A
Expiration Date*

MonthDayYear
Date
Student's Phone*

Area CodePhone Number
Does the driver have any special accommodations we should be aware of (504 Plan, IEP, etc.)? If yes, please describe.
Refund/Drive Policy

Towne Lake Driving School does not offer refunds. All contracts are good for one (1) year.

If registering for multiple drives, please be prepared to spread the drives out to allow for adequate practice between instruction. (We schedule drives no closer than 3 weeks apart). In addition, our calendar is typically running 2-3 weeks out before we may have a drive available. Please feel free call the office before registering to check on our up to date calendar availability. 678-494-2200
Confirmation

BY CLICKING THE SUBMIT BUTTON, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE. I ALSO CONFIRM THAT I AGREE WITH TOWNE LAKE DRIVING SCHOOL'S PRIVACY POLICY.
Should be Empty: