117 S Kent St, Winchester, VA 22601
Select the course you want to take with Valley Driving School
Click on the link, complete the form and submit.
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Learn to Drive Safely in the Shenandoah Valley and Beyond!
Learn to Drive Safely in the Shenandoah Valley and Beyond!
REGISTER NOW
DOWNLOAD PDF FORMAT
WITH ADOBE READER. SEND COMPLETED REGISTRATION FORMS VIA EMAIL TO:
valleydrivered@gmail.com
When you email your form include your NAME AND PHONE NUMBER
in the body of the email in case we have difficulty reading the form.
If you DO NOT receive a reply to your email with the registration form within 24 hours
call 540 398-6059 because we did not receive it if you do not hear from us.
FCPS students sending the form with an email ending in fcpsk12.net are having difficulty sending this attachment. Take a picture of the form and text it to the above
phone number.
WITH ADOBE READER. SEND COMPLETED REGISTRATION FORMS VIA EMAIL TO:
valleydrivered@gmail.com
When you email your form include your NAME AND PHONE NUMBER
in the body of the email in case we have difficulty reading the form.
If you DO NOT receive a reply to your email with the registration form within 24 hours
call 540 398-6059 because we did not receive it if you do not hear from us.
FCPS students sending the form with an email ending in fcpsk12.net are having difficulty sending this attachment. Take a picture of the form and text it to the above
phone number.
CREDIT CARDS ACCEPTED FOR THE 36 HR online course and ADULT BTW sessions
REGISTRATION FORM - PDF format
REGISTRATION FORM - WORD DOC format
ONLINE 36 HR COURSE - PDF format
ONLINE 36 HR COURSE REGISTRATION - WORD DOC format
Contact Us / Register for a course
____________________________________
NAME:
(Print as appears on you Learner’s Permit)
____________________________________
MAILING ADDRESS:
(List the home address where the driver may be picked up or dropped off)
____________________________________
DRIVER EMAIL:
____________________________________
NAME OF HIGH SCHOOL you attend
____________________________________
PARENT EMAIL: (if under 18)
____________________________________
DRIVER CELL PHONE:
____________________________________
PARENT CELL PHONE: (if under 18)
____________________________________
LEARNER’S PERMIT #:
____________________________________
DATE ISSUED:
____________________________________
DATE OF BIRTH:
____________________________________
AGE YOU ARE TODAY:
____________________________________
DEC1 CARD # (green card for under 18 drivers)
____________________________________
COURSE INTERESTED IN REGISTERING FOR:
____________________________________
BEHIND THE WHEEL TRAINING FOR TEEN UNDER 18 - $325
____________________________________
BEHIND THE WHEEL TRAINING FOR ADULT (18 & OLDER) - -$50 PER SESSION
____________________________________
8 HR DRIVER MANUAL COURSE - $225
(needed if client fails the learners permit test 3 times. Clients under 18 must have completed the 36 HR classroom course and hold the certificate from that course)
____________________________________
WHAT DATE WOULD YOU BE AVAILABLE TO START THE COURSE:
____________________________________
LIST ANY CONFLICTS OR TRIPS YOU HAVE PLNNED WITHIN 3 WEEKS OF THE ABOVE DATE:
____________________________________
WHAT IS YOUR DISMISSAL TIME FROM SCHOOL EACH DAY:
____________________________________
DO YOU PARTICIPATE IN ANY AFTER SCHOOL SPORT/ACTIVITY DURING YOUR REQUESTED TIME PERIOD
WHAT TIME DOES PRACTICE END?
LIST THE NAME OF ANY STUDENT DRIVER YOU WOULD LIKE TO PARTNER WITH FOR THE COURSE:
____________________________________
____________________________________
NAME:
(Print as appears on you Learner’s Permit)
____________________________________
MAILING ADDRESS:
(List the home address where the driver may be picked up or dropped off)
____________________________________
DRIVER EMAIL:
____________________________________
NAME OF HIGH SCHOOL you attend
____________________________________
PARENT EMAIL: (if under 18)
____________________________________
DRIVER CELL PHONE:
____________________________________
PARENT CELL PHONE: (if under 18)
____________________________________
LEARNER’S PERMIT #:
____________________________________
DATE ISSUED:
____________________________________
DATE OF BIRTH:
____________________________________
AGE YOU ARE TODAY:
____________________________________
DEC1 CARD # (green card for under 18 drivers)
____________________________________
COURSE INTERESTED IN REGISTERING FOR:
____________________________________
BEHIND THE WHEEL TRAINING FOR TEEN UNDER 18 - $325
____________________________________
BEHIND THE WHEEL TRAINING FOR ADULT (18 & OLDER) - -$50 PER SESSION
____________________________________
8 HR DRIVER MANUAL COURSE - $225
(needed if client fails the learners permit test 3 times. Clients under 18 must have completed the 36 HR classroom course and hold the certificate from that course)
____________________________________
WHAT DATE WOULD YOU BE AVAILABLE TO START THE COURSE:
____________________________________
LIST ANY CONFLICTS OR TRIPS YOU HAVE PLNNED WITHIN 3 WEEKS OF THE ABOVE DATE:
____________________________________
WHAT IS YOUR DISMISSAL TIME FROM SCHOOL EACH DAY:
____________________________________
DO YOU PARTICIPATE IN ANY AFTER SCHOOL SPORT/ACTIVITY DURING YOUR REQUESTED TIME PERIOD
WHAT TIME DOES PRACTICE END?
LIST THE NAME OF ANY STUDENT DRIVER YOU WOULD LIKE TO PARTNER WITH FOR THE COURSE:
____________________________________
Contact us at (540) 398-6059 to learn more about our driving school.