CTS Commitment To Safety Driving School

1550 Prince William Pkwy, Woodbridge Va. 22191

(703)919-8447 Fax (703) 590-4246

gttime44@comcast.net

Gary Tibbs

Driver’s Ed/Classroom Agreement:

This agreement entered into this _____ day of ___________, 20___ between

CTS Driving School, located at 1550 Prince William Pwy, Woodbridge Va. 22191

Full Name: ______________________________________________________________

Last First Middle

Birth Date: ____________Male ___ Female___ Email Address: _____________________

Permit/License Number: __________________ Issue Date: _________

Address: _______________________________City/State/Zip:_____________________

Phone Number: _______________ Cell Phone:_____________________

Parent / Guardian Address: ______________________________________________

Emergency Contact Person: ______________________Phone Number: ____________

Are you taking any medications: Yes____ No_____(if yes, please describe)_______________

List any other medical conditions or learning disabilities: ________________________

Start date____________ Ending date_______________

The following conditions need to be understood before enrolling.

1. Course consists of 36 periods of classroom instruction for under 18 years of age, at cost of $175.00 (Each period is fifty minutes long).

2. Students who obtained a learner’s permit at age 18 years or older and who have held the learner’s permit for at least 60 days, are not required to attend driver training school.

3. Students will receive no more than (4) periods of instruction on weekends and holidays, no more than (2) periods of classroom instruction on regular school days.

4. Student will be notified by phone call in the event the school cancels classes. Cancelled classes will be made up at the end of the course.

5. Classes are held Monday, Tuesday, and Thursday 5:00 p.m. to 9:00 pm.

6. A refund of all fees paid will be made, upon request, if school is not capable of or willing to begin instruction within 30 calendar days from the date agreed to in the contract.

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7. This contract is valid for 6 months from the first classroom session.

8. CTS does not guarantee that any student will pass the state license examination or

that the student can secure a license, or that student will be guaranteed employment

upon completion of any course instruction.

9. A thirty-five dollar ($35.00) fee will be charged for any non-sufficient fund or stop

payment check that is returned by a bank. Issuer of the check will be responsible for

legal expenses.

10. Replacement of DTS-B will be for $10.00 processing fee.

11. Students are fully accountable for their conduct. Any damage done by a student to school property, building, or parking lot will result in the student being immediately dropped from the program with NO refund given. Any payment necessary for the damage will be the responsibility of the student or parent/guardian. Criminal activity will be reported to the local authorities, as well as the student's parent/guardian.

12. Sleeping, talking or cell phone use is not allowed during class lectures, videos, or in the automobiles during drive or observation time. Anyone found sleeping, talking or using cell phone during these times will be considered absent and will not be given credit for their attendance. All students hereby agree to keep areas in the building, classroom, parking lot and automobiles clean from all litter and debris.

13. Any student suspected of being under the influence of alcohol or drugs while attending class or road instruction will be immediately dismissed form the program. A conference will be held with their parent/guardian as well as the local law enforcement officials being contacted. Also, NO refund from the program will be given.

14. ATTITUDE and MATURITY are an important part of this course. Any student who is found DISRUPTIVE or DISRESPECTFUL to the instructor, other students or anyone associated with CTS Driving School shall be dismissed by the instructor at the instructor's discretion. The refund policy shall apply.

15. It is the responsibility of the student or in the case of minor the parent or legal guardian to report to the Department of Motor Vehicles any concerns regarding school facilities, instructor behavior or quality of instructions by the school.

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In the event that the student cannot take or complete the driver education

program, the refund policy is as follows:

1. Refund of the tuition LESS a twenty-five ($25.00) fee for processing, before the program start.

2. Dropping or being dismissed from the program after the program begins but before completion of the third class meeting, two-thirds of the total cost of the program will be refunded.

3. Dropping or being dismissed from the program after completion of the third class

meeting, no refund will be given. We have read this contract and agree to abide by the conditions.

Student's Signature _____________________ Date ______________

School Representative's Signature _____________________ Date __________

I hereby request that my son/daughter ________________________, be enrolled in a state approved classroom instructions program.

Parent or Legal Guardian Signature __________________________ Date ________

DMV is committed to promoting transportation safety through the certification of quality driver training programs. If you have comments or concerns about this course, call DMV at 1-877-885-5790 or email dmvclu@dmv.virginia.gov

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