Pre-registration form
with classes in Findlay and Bluffton, Ohio
I would like to begin class
Drive Time Driving Instruction classes
ServUs Center
2469 S. Main Street
Next class begins Sept. 22
Bluffton Entrepreneurial Center
505 E. Jefferson Street
Next class begins Oct. 6

Drive Time Driving Instruction
Name as it appears on your permit
(first, middle-if included, last)
Street address
City, State, Zip
Home/primary phone
Your cell number
Email address
Permit number
(no permit yet, no problem)
Permit date
High school
Restrictions to driving times (church, athletics, 4-H, band, etc.)
Special medical considerations (allergies, etc.)
Mother's name
Mother's cell
Father's name
Father's cell
Other questions/comments?
County (Hancock, Allen, etc.)
Is this your first permit?
Approximately how many hours
have you driven with your parent(s)?