Creating Quality Drivers
Class Type----Segment 1Segment 2
Class Selection----Brown City - Nov 2, 2026Capac - Oct 5, 2026Lapeer - June 8, 2026 (FULL)Lapeer - Aug 10, 2026 (Segment 1 FULL)Lapeer - Sep 7, 2026Lapeer - Nov 30, 2026Peck - Jul 13, 2026 (Segment 1 FULL)
First Name
Middle Name
Last Name
Segment One Student MUST be minimum of 14 years, 8 months old at first class meeting date. Students Date of Birth
Students Address
City
State
Zip
Parent / Guardian Name
Parent / Guardian Phone with dashes
Email Address
I understand that this is just a "Pre-Registration" and my seat is not guaranteed until I have received confirmation from Patriot Driving School LLC. Scheduled Class Locations, Dates, and/or Times may adjust due to building availability, time conflicts, unforeseen events, etc.