Integrity Driving School, LLC
203 N. Collins Street
 P.O. Box 1125
Fowlerville, MI 48836
(517) 521-2093

Segment 2 Contract

Program Number #_______________                                                                                                        Class Date:___/____/____
(Assigned by provider)

Student’s Name:______________________________________________________________________
                                                        Last                           First                          Middle

Address:______________________________________________ City:_______________  Zip:_______

Age: ______ Date of Birth:____/____/____ (Please provide birth certificate for verification)

Home Phone #:______________________     Cell phone #:___________________

Parent/Guardian’s Name:________________________  Work Phone #:_____________________

Address if different than the student:_______________________________________________

How did you hear of us:_____________________________________________

REQUIRED LANGUAGE
NOTICE- This provider is required to be certified by the Secretary of State.  If you have any complaint, with you cannot settle with this provider, write:  Michigan Department of State, Driver Programs Division, Lansing, MI 48918.  Completion of driver education instruction does not guarantee qualification for a driver license.

Terms & Conditions

1.	Integrity Driving School, LLC will provide 6 hours of classroom instruction provided by a certified instructor. *Classroom instruction shall not exceed 2 hours per day.
2.	For a student to participate in Segment 2, verification must be received that the student has completed a minimum of 30 hours of driving (including 2 hours at night) with a licensed parent or guardian on a Level 1 License, which has been held for less than 3 continuous months.
3.	The parent or guardian agrees to pay the amount of $50. This must be paid in full by the first day of class. We accept cash and checks. Returned checks are subject
4.	Classes are filled according to the order in which the contracts are received.
5.	The required score to pass the state test is 70%.
6.	In case of a student’s absence or emergency the school’s policy is the time will be made up at the instructor discretion.
7.	Cell phones, I-pods, etc. are not allowed to be used during classroom or road instruction.
8.	Smoking is not allowed in the building, on school grounds, or in the automobile.
9.	If the student shows up for class or driving session under the influence of alcohol or drugs they will be IMMEDIATELY DISMISSED.
10.	Any vandalism to the classroom or vehicles will result in IMMEDIATE DISMISSAL and the refund policy will be null and void.  The student will be responsible for any repair cost.

Refund Policy

If for any reason, a student decides to withdraw from the course, Integrity Driving School must be notified prior to the first day of class for a $50 refund. 

The undersigned acknowledge and represent that they have reviewed and examined each of the aforesaid agreements, provisions and that they will be bound by same.

___________________________________                 _____________________________________

Student Signature                                                           Parent or Guardian Signature

___________________________________                 _____________________________________

Date                                                                                Integrity Driving School Manager