Driversity Driving School
288 Sally Ride Drive
Concord, California 94520

*Is a required field


* Student's first and last Name
* Address
* DOB: mm/dd/yyyy
*City
, CA

* Phone:
*Cell Phone:
* Student

* High School Student Attends :  

 



Parent or Guardian First and Last Name:
* Phone:
* Cell Phone:
* Parent e-mail :
Additional Info

Enter student staus (ie, former, current or new) in the box to the right. *Student Status:
Please acknowledge that you have read and the following terms and conditions by entering your initials in the box below.
1. It is agreed that you are enrolling in Driversity's driver training course.

2.

It is agreed that a non refundable administrative enrollment fee for enrollment is assessed. The driver training enrollment fee is $15.
3. It is agreed that you may have the certificate sent to you or you may pick the certificate up from the Concord office between 12pm and 4pm M-F.
4. You are acknowledge that you are within the range of the concord location. If you are not see the note above at the top of this form.
5. You understand that once the certificate is issued the fee is not refundable for any reason.
6. You have read the 1-5 above.
Enter Initials here:


* Student Signature

The administrative fee is $15. You can pay this fee online. Once you click the submit button you will be routed to the tuition page to pay the fee. You can also call the office at 925.691.4440 and make arrangements for payment.