Adult Driver Training Course Registration
Accept Refund/Cancellation policy
Type full initials of submitting individual
Legal FIRST Name
Legal Middle Name
Legal LAST Name
Email Address
Gender
Home Phone Number with area code
Cell Phone Number with area code
Date of Birth (MM/DD/YYYY)
Street Address
Apartment number (if applicable)
City, State, Zip
Desired Start Date
Purpose for Taking Class
Native Language
English Speaking Fluent?
Yes
 No
Driver License number
State where LIcense was issued
Month & Year License was issued
Type of license held
Have you tested with DPS Behind
the Wheel yet?
Yes
 No
Payment of Registration?
Certificate Delivery Desired

    ALL Registrations MUST be submitted with a deposit payment of tuition for instruction.  
    Please proceed to "PAY ONLINE" page of this website to complete your registration
    process.  

    Come in to the office at 5135 69th Street, Lubbock; OR Call 806-794-5397
    to plan your education and your first day of instruction in Defensive Driving class.