Top Notch Driving Academy - Class Schedules


	Registration for Classes

Online Registration (for Segment 1)

Online registration is fast and easy. Please note that you are required to bring a certified birth certificate to the first class.

Note: Online registration does not guarantee a placement in class. You will be contacted regarding scheduling and placement.

Indicates required information (If a required field is not applicable to you, please put an n/a* in that field) This form is also available in pdf format
*Student Full Name	(last, first, middle)
*Address line1
Address line2	City: State: *Zip:
*Home Phone
*Birth Date	(mm,dd,yyyy) VERIFIED BY BIRTH CERTIFICATE (1^st Class Night) Student must be at least 14 years 8 months by the first day of class.
*Email

*Parent/Guardian's Name	Work Phone Cell
*Emergency Contact	*Phone

*Preferred Class Dates

Yes No	*1. Does the student require any special accommodations to participate in the classroom phase (i.e., test read to him/her, an interpreter, seating arrangements, etc.)?
Yes No	*2. Does the student require any special accommodations to participate in the behind the wheel phase (i.e., adaptive devices, an interpreter, etc)? If yes, please explain:
Yes No	*3. Is the student taking any medications that may affect his/her ability to drive a motor vehicle? If yes, please explain:
Yes No	*4. Are there any medical conditions that would pose a concern with the student's behind the wheel instruction (epilepsy, asthma, color blindness, hearing loss)? If yes, please explain:
Yes No	*5. Is the student's visual acuity at least 20/40 corrected?
Yes No	*6. In the last six months, has the student had a fainting spell, blackout, seizure, or other uncontrolled loss of consciousness?
Yes No	*7. In the last six months, has the student had a physical or mental condition which affected his/her ability to drive a motor vehicle safely?
*If the answer to question 5 is no, or either of questions 6 or 7 is yes, then the parent/guardian must provide a letter signed by the student's physician indicating that then condition has been corrected and/or is under control, and the student meets the physical and mental requirements for a motor vehicle operator's license under Section 309 of the Michigan Vehicle Code, 1949 PA 300, MCL 257.309.
	*CERTIFICATION: I certify that the information on this form is true and accurate to the best of my knowledge.
Date	(mm,dd,yyyy)

Download Registration Form

If you prefer, you can download and print out our registration form to fill in.