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JUNE./AUG. 2017 Goffstown HS
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CLASS HELD AT GOFFSTOWN HIGH SCHOOL



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 Goffstown High School / Mr. Ross' Driving School 
         Cell: (603) 661-3547
 
 BEFORE SENDING IN THIS ENROLLMENT APPICATION

 The following 5 items must be completed.
1) To be allowed to take Driver Education, your son/daughter must have passed two High School classes the previous quarter or Guidance Counselor Written Approval

2)  Must be 16 by the conclusion of the course (State law).

 

  3)  VISION: ______________N   ______________F   Uses glasses/contacts

 

       Signature of School Nurse _____________________________________

 

  4)  ____ Birth Certificate enclosed (no originals please, copy only)

 

1)             ____ Check enclosed for $625. made out to: Mr. Ross’ Driving School.  (Mail check, forms, birth certificate, to Mr. Ross’ Driving School, 12 Mercury Dr. Londonderry, NH 03053)

 

PLEASE PRINT FULL LEGAL NAME

 

Name______________________________________________________________________

                                                           (First, Middle, Last)

 

Address:____________________________________________________________________

                                                             (Street, City, State, Zip)

Student Home Phone: __________________       Date of Birth: _____________________

 

Parent Name(s): ____________________________________________  Work # ____________

 

Mailing Address (if different): ____________________________________________________

 

FOLLOWING MUST BE FULLY COMPLETED

 

Free Periods/Study Halls/Lunch-Study:  _______________________________________

(please include ALL free periods, not just lunch periods)

 

DRIVING WILL NOT NECESSARILY BE DONE ON THE SAME DAY AS CLASS.  CIRCLE EACH DAY YOU WILL BE AVAILABLE.

It is HIGHLY RECOMMENDED that you have a free period besides lunch

 

After School Driving (Circle):   M   T   W   Th   F            Saturday Driving:  Yes___   No___

IMPORTANT:  Applications are accepted on a first-come, first-serve basis and driving time availability.  Student will be registered only upon receipt of completed forms, copy of birth certificate and check. 

 

 

 
 
 
 

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Mr. Ross' Driving School
12 Mercury Dr. Londonderry, NH 03053 

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