Georgia Driving Coach Registration

Student Official Name *

Student Date of Birth *

Student High School *

How did you hear about Georgia Driving Coach? *

Parent First Name *

Parent Last Name *

Best contact phone number *

Parent Email Address *

Street Address *

Address Line 2

City *

State *

Zip Code *

Select Classroom Dates and Course Offerings

Select 30hr Joshua's Law Classroom Dates
Dates only need to be selected if signing up for Classroom Option

Teen Drivers Ed Package Options *

30hr Classroom + 6hr In-Car Training ($499)

30hr Classroom + 10hr In-Car Training ($699)