BOX ELDER HIGH SCHOOL REGISTRATION FORM FOR DRIVER

BOX ELDER HIGH SCHOOL
REGISTRATION FORM FOR DRIVER EDUCATION: Spring(3rd) TRIMESTER 2015
Please Print:
Student’s Name:_____________________
EMAIL: ___________________________
Date of Birth:_________________________
Phone: _________________________
Students must be 15 by March 1, 2015 to register for spring trimester. Three (3) sessions will be offered. Please
check the dates and time for each session and make sure that you can be there each day. State Law requires 30 hours
of classroom instruction. MAKE UP is very difficult. Students not completing the thirty hours of class instruction
will fail the class. NO EXCEPTIONS.Along with the class, students will be required to drive 6 hours on the road
and observe for 6 hours in the Driver Education car. These sessions will be scheduled individually with the
students. The registration fee for Driver Education is $195. This is collected on the 2ndday of class.
PLEASE CHECK ONLY ONE SESSION
[ ] 1.
Mar. 16 – Apr. 27
Time: 3 pm to 6 pm
J-2
BEHS
[ ] 2.
Mar. 17 –Apr. 28
Time: 3 pm to 6 pm
A-2
BEHS
[ ] 3.
Mar. 21 – May 23
Time: 7 am to 10:20am
P-4
BEHS
[ ] 4.
Electronic High School Version ---- Register online at http://www.behs.besd.net/driversed/driversed.htm
4. March 31 - Optional Parent/Teen nightTime: 6 pm to 8 pm
*See Attached Flyer for information about Parent/Teen night
BEHS Auditorium
This top portion of this form must be returned in order for the student to be registered. Please return to Mr. Burt in
room A-2, or the main office at Box Elder Middle/High School as soon as possible. Classes are filled on a “firstcome, first- served” basis. Once a class is full, it is full. If the registration form is turned in, then the student is
registered unless notified by the instructor.
Parent Signature __________________________
Student Signature ___________________________
____________________________________________________________
(Detach bottom portion and keep for your records)
Your student is registered to take Driver Education at Box Elder High during this year’s spring trimester.
PLEASE CHECK ONLY ONE SESSION
[ ] 1.
Mar.16 – April 27
Time: 3 pm to 6 pm
J-2
BEHS
This class will be held on Mondays and Wednesdays. The dates for all the class sessions are: Mar. 16, 18,
23, 25, 30, Apr. 1, 13, 15, 22, 27* (No Classes held on April 6, 8, or 20)
[ ] 2.
Mar. 17 – April 28
Time: 3 pm to 6 pm
A-2
BEHS
This class will be held on Tuesdays and Thurdays. The dates for all the class sessions are:Mar. 17, 24,
26, 31, Apr. 2, 14, 16, 21, 23, 28* (No classes held on Mar. 19, April 7 and 9)
[ ] 3.
Mar. 21 – May 23
Time: 7 am to 10:20 am
P-4
BEHS
This class will be held on SATURDAYS. The dates for all the class sessions are: Mar. 21, 28, Apr. 4, 18,
23, May 2, 9, 16, 23. (No class held on April 11)
QUESTIONS: Visit http://www.behs.besd.net/driversed/driversed.htm or contact us directly.
Mr. Peter Burt435-279-0121 (class 2)
Mr. Gregg Cefalo435-279-3218 (class 3)
Mr. Donny Constantineau 435-279-7920 (class 1)
Mr. Tom Davidson435-740-4108(Electronic Class)
The student is expected to be ready to work, with paper and pencil on the first day of class. The textbook and the Utah Driver
Handbook will be provided. The cost of the program is $195 ($55 for the classroom and $140 for Road Instruction). Fee-waivers do apply. This
is to be paid on the second day of class, if possible. Please make checks payable to BEHS.