Parent Student Contract - Agganis Driving School

1 580 Main Street Reading, MA 01867 Local: Fax: Parent Student Contract Mass Dept. of Transportation Fees These fees are additional and paid by you directly to the MassDOT. Learners Permit $ *Driver Education Certificate $ License Application $ Five Year Picture License $ I acknowledge that by attending and successfully completing the driver education program with Agganis Driving School , and after passing a road test conducted by the Massachusetts Dept of Transportation, I will be eligible to receive my driver s license when I turn 16 years old. In addition, I will receive a certificate of completion that will save me up to $1, on my automobile insurance for the first three years (see below for details).

2 I understand that if I decide not to participate in a driver education program I cannot receive a driver s license in the state of Massachusetts until I turn 18 years of age, and therefore will not be eligible for the insurance discount. Payments Payment for the classroom and Driving portion of the program must be paid in full prior to or on the first day of class. We accept several forms of payment: cash, check, money order, MasterCard, Visa & Discover and debit cards. Insurance Discounts To be eligible to receive 10% off a Massachusetts automobile insurance policy a Student /driver must: 1) Have held a learners permit in good standing for a minimum of six months 2) Have successfully completed Driver Education with Agganis Driving School 3) Have received a Driver Education Certificate of Completion 4) Have passed a road test conducted by the Massachusetts Department of Transportation.

3 Please review the following information and state your agreement regarding the driver education certificate issued by the Mass Dept. of Transportation and also Agganis Driving School s 24-hour cancellation policy. Driver Education Certificate and MassDOT Fee I understand that upon successful completion of the Massachusetts minimum requirements of 30 hours of classroom instruction, 12 hours of behind-the-wheel instruction, 6 hours of observing another Student drive, and the 2 hour Parent class. My certification for the course will be processed through the Mass Dept of Trans. The fee for this electronic certification is $ * and must be presented to the classroom instructor along with this Contract on the first day of class.

4 (This is a MassDOT fee and can be paid in cash or check form payable to Agganis Driving School . Please include and print Student s full name on check.) Please Initial: P_____ S_____ Parent Class Parent class must be complete before the Student can schedule the on road Driving lessons, the fee for this class is *$ , must be paid with cash upon arriving of your scheduled Parent class. Please Initial: P_____ S_____ Driving Lesson Cancellation Policy I hereby acknowledge that if I must cancel a Driving lesson, I/we will call Agganis Driving School as soon as possible to avoid the cancellation fee. I am aware that if I do not cancel a Driving lesson at least 24 hours in advance, there will be a *$ cancellation fee.

5 I further understand that if payment is not made on or before my next Driving lesson, all previously scheduled lessons will be cancelled until full payment has been received. Please Initial: P_____ S_____ By signing & initialing this form I/we are stating that we understand all the services and fees associated with attending Agganis Driving School , obtaining a drivers license in Massachusetts, and receiving text message alerts by cell phone. Date_____ *all Agganis and MassDot fees are subject to change without notice. students Name: Last:_____ First:_____ Signature_____ (print) (print) parents Name: Last:_____ First:_____ Signature_____ (print) (print) (Please print two copies & keep one copy for your record) Agganis Driving School COPY Received_____ Location_____ By checking this box I am indicating that I DO NOT WISH to have Pictures/Video taken/posted of my child.

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