BEHIND THE WHEEL

DRIVER EDUCATION, LLC

Student Contract
Segment 2
Dept. of State Certification #: N002824
14879 Hilltop Drive
Cement City, Michigan 49233
517-688-4300 or 517-206-3349
Office Hours: By appointment only.
Class location Michigan Center High School,
400 S. State Street Michigan Center 49254
Students Full Name _______________________________________________
(last)
(first)
(middle)
Age ______

Birth date (

/
/
)
(mo.) (day) (yr.)

______ Teen Student (14.8 to 17 years)

*For a student to take part in Segment 2, verification must be received that the student
has completed a minimum of 30 hours of driving (including 2 hours at night) with a
licensed parent or guardian (or parent designee) on a level 1 license, which has been
held for not less than 3 continuous months.
Address ____________________________________________________________
(street)
(city)
(zip)
Phone Number (_____)____________________
Parent/Legal Guardian Name ___________________________________________
(Last)
(First)
Address ____________________________________________________________
(street)
(city)
(zip)
Phone Number (

)_____________________

Make checks payable to Behind the Wheel Driver Education Cost for Segment 2: $45.00
Payment Method (cash or check) Check. # ______ Date of check ________ Paid ______
(Payment must be received by the first day of class. *$35.00 return check fee)

There are no materials fees. The instructor will supply all materials.

The driving record of each individual instructor is available for review upon request.
*Notice: This provider is required to be certified by the Secretary of State. If you have any
complaint, which you cannot settle with this school, write: Michigan Department of State, Driver
Programs Division, Lansing, MI 48919. Completion of driver education instruction does not
guarantee qualification for a driver license.
Requirements to pass the course and receive certificate/driving permit:

Segment 2: Course will consist of 6 hours of classroom instruction and shall not exceed
2 hours of instruction per day. There will be 3 scheduled days of class. Time missed for
any reason, will have to be made up within 1-2 weeks after the session was originally to
be finished. The cost of each make-up session will be an additional $25.00.
All homework assignments must be completed and handed in.
All assignments and homework must be passed with 70% accuracy or better.
The final evaluation, the Secretary of States Knowledge Test, must be passed with 70%
accuracy or better.
Refund Policy: If a student cannot complete the course due to illness, family situation, etc.,
upon written notification to the instructor, the student may be reimbursed for the amount of
class time not attended at $8.00 per hour.
_______________________________
(Student Signature)

_______________________________
(Parent/Guardian Signature)

Michael Bruner
(Instructor Signature)

____________________
(Date)

BEHIND THE WHEEL

Segment 2, Driver Education Student Record Form
Level 1 Driver License #: ______________________________________
Level 1 License Date of issuance _______________________
Driver Log/# of hours __________Day __________Night

___________________________________
Parents Signature For Verification