(856) 235-7333 info@southjerseydrivingschool.com 300 Chester Ave. Suite 206 | Moorestown, NJ 08057

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Home
About Us
- About Us
Services
Blog
FAQs
PRACTICE TEST
Schedule Your Road Test
Testimonials
Resources
Contact
Enroll

Senior Citizen Registration

Student Name(Required)

First Last

Student Phone(Required)

Student Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Student Birthday(Required)

MM slash DD slash YYYY

Driver's License #(Required)

This # is located above your name on your permit. It begins with the first letter of your last name and is followed by 15 digits in black ink.

Validation #:(Required)

This is a 5-digit hand-written number located on the bottom portion of your permit.

Parent/Alternate Name(Required)

First Last

Parent/Alternate Email

Parent/Alternate Phone

As the student, I certify that all statements are true.(Required)

As the student, I certify that all statements are true.

I allow the use of photos of myself/the student in social media, website, and print material for South Jersey Driving School, Inc.(Required)

I allow the use of photos of myself/the student in social media, website, and print material for South Jersey Driving School, Inc.

Additional Details/Comments?

Please provide any information that would help us know your situation, including if you already have your permit to drive. If so, please provide the date, time, and location of your appointment.

How did you hear about us?

If other, please tell us how you heard of us...

Product Name

Price:

Please select a Driving Program

Behind-the-Wheel 90-Minute Driving Lesson and Evaluation

Deposit

Deposit(Required)

A minimum of 150.00 is required.

CASH ONLY Services

Please note that these services are CASH ONLY and payable on the day of the service. Deposits will not be applied towards these options.

* Please contact our office about rates for pickup from home*

Written Test Prep Class - $75.00

Road Test Service - $145.00

Pay Now or Later(Required)

Please select "Pay Full Balance in Office" if you are only ordering CASH ONLY services.

Pay Now

Pay Full Balance in Office

Credit Card Payment Convienence Fee

Price:

Total Due Now

Payment Information

Does your student information match your billing information?(Required)

Yes

No

Billing Name(Required)

First Last

Billing Phone(Required)

Billing Email(Required)

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Month Year Expiration Date

Security Code Cardholder Name

Important Information

DUPLICATE STUDENT PERMIT SERVICE CHARGE - $35.00.
STUDENT MUST CANCEL NO LESS THAN 24 HOURS IN ADVANCE OR BE RESPONSIBLE FOR FULL PAYMENT OF LESSON.
ROAD TEST SERVICE IS CASH ONLY.
NO REFUNDS AFTER LESSONS BEGIN (OR) 3 MONTHS AFTER PAPERWORK IS RECEIVED.
IF USING OUR ROAD TEST SERVICE – CALL US 24 HOURS IN ADVANCE TO CONFIRM AND LEAVE YOUR PHONE NUMBER.

Comments

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