Registration FormREGISTRATION FORM Today's DateMVA Courses36 - HOUR DRIVER EDUCATION30 - HOUR DRIVER EDUCATION PROGRAM (CLASSROOM ONLY)6 - HOUR DRIVER EDUCATION (BTW)3 - HOUR ALCOHOL AND DRUG EDUCATION4 - HOUR DRIVER IMPROVEMENT PROGRAMMVA ROAD TEST CARE RENTALDRIVING MENTORSHIP/ PRIVATE PRACTICE (2 HOURS)DRIVING MENTORSHIP/ PRIVATE PRACTICE (4 HOURS)DRIVING MENTORSHIP/ PRIVATE PRACTICE (6 HOURS)DRIVING MENTORSHIP/ PRIVATE PRACTICE (8 HOURS)DRIVING MENTORSHIP/ PRIVATE PRACTICE (10 HOURS)Student Information(To be completed by student/parent/guardian)First NameLast NameDate of Birth Gender- Select -MaleFemalePrefer Not to AnswerPhone/MobileEmailLerner's Permit #AddressAddress Line 1Address Line 2CityStateZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweSchool AttendingPayment DetailsNo payment items has been selected yetTaxPay with Card (Stripe)TDS AgreementReceipt of the document constitutes a contract between Top Driving School and the student to whom it is assigned. This contract should be signed by a school representative and the student. Any student under 18 years of age must have this contract signed by their parent or guardian. Top Driving School will provide service to the student which will meet the requirements for Driver Education in the State of Maryland. For students under the age of 18, 30 hours of classroom instruction and 14- 50 minute periods of in-car instruction (seven periods of actual driving and seven periods of observation) need to be completed in order to secure a driver’s license. Drivers over the age of 18 are considered adult drivers and are not required to attend a driver training school in order to secure a driver’s license.Top Driving School does not guarantee that any student will pass the Road Skills Evaluation needed in order to secure a driver’s license. (If students are unsuccessful passing the driving test on the 1st attempt, they may re-test up to 2 additional times. $15 fee will apply for each re-test). Rates for Driver Education for teenage students and adults are based on a package program. Rates will be listed on this document and acknowledged by the parent's signature. Any student requesting Top Driving School to accompany them for a road test at the DMV will pay a minimum of two hours of the contracted price or however long it takes. Additional training or testing is available at the rate listed on the rate sheet.The refund policy is as follows: All refunds must be requested in writing. Refunds will be paid between ten days to four weeks from the date of receipt of the written request. No refund will be made after four lessons of in-car instruction. All refunds paid before four lessons will be pro-rated and the balance will be refunded. No refund will be made after one-hundred twenty days of the date of this contract.Top Driving School Agrees to:Provide a certified driving instructor with properly marked automobiles to students for the driving session.Abide by and enforce the laws of the Maryland Division of Motor Vehicles (DMV) during instruction.Keep the proper records as required by the DMV and submit same as required by the DMV.Faithfully serve the students and pledges itself to the public to conform to the highest standards of driving instruction.Provide 14 in-car instruction periods, 7 periods of driving, and 7 periods of observation (50 minutes each/Behind the Wheel Instruction only). Road tests are included and given on the last day.Every student passing the Behind the Wheel course will be given a DMV certificate at the end of the course. Certificates are only valid on the day the student has held a learner’s permit 9 months.Refund associated fees upon request if the driving school is not capable of performing the school's part within one year from the date of the reverse side of this form.We charge a $35 fee for returned checks as well as a $35 fee for scheduled appointments canceled without a 24- hour notice. This is a policy enforced by the Top Driving School and will be issued without exception.Direct (30 hours/36 periods) of state-approved driver education classroom periods, including components about alcohol safety, drug abuse awareness, aggressive driving, distracted driving, motorcycle awareness, and organ and tissue donation awareness (for classroom instruction only).Reschedule missed/canceled appointments within 30 days or as agreed upon between both parties.The Student/Adult Agrees to:Pay for all instruction at the beginning of the course of instruction.Forfeit all money for uncompleted instruction if offered, but not taken advantage of within one year from the date on the reverse side of this contract.Be under the driving school's supervision during any scheduled and non-scheduled instruction.Possible dismissal for failure to follow the driving school guidelines, rules, instruction, and/or Maryland DMV laws with no refunds. Mature behavior is expected.Understand that the instruction provided does not guarantee that any student will pass the state license examination or that the student will be guaranteed employment upon completion of any course of instruction.Pay a fee in accordance with the fees established by the associated driving fee chart or by special agreement.Pay a deposit for class reservations as outlined in the fees chart, which will be applied to the remaining balance at the start of class. Deposit is non-refundable if the student does not attend the scheduled class.Show proof of completion of a (30 hour) state-approved driver education program and hold his or her Maryland learner's permit for at least nine months and be at least 16 years and 3 months of age to obtain a Maryland driver's license (Maryland resident under age 18 only).Adults must hold a Maryland learner's permit for at least 60 days or show completion of a state-approved driver education program (Maryland residents, 18 years of age or older who have never held a license issued by any state, U.S. territory or foreign country only).Meet the observation requirement with at least one other student in the vehicle during in-car training in the event that one-on-one driver training is permitted (Maryland residents under the age of 18). Adult/Student/Parent Guardian signature: ___________________________________ Date___________Note: Successful completion of a State-Approved Driver Education course does not imply that the student is an accomplished driver. No one can be considered an average skilled driver until he/she has driven for three to five years.DMV is committed to promoting transportation safety through the certification of quality driver training programs. If you have comments or concerns about this course, call our toll free number: 1-877-885-5790Submit Form