Apple driving school

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4895 STODDARD TROY, MI 48085

(248) 689-8224

PLEASE PRINT CLEARLY (You must be 14 yrs 8 months by the first day of class)

***Please bring a copy of your birth certificate that we can keep to the first class***

LEGAL NAME_______________________________________________________________
First Middle Last

Street City Zip

HOME PHONE #_______________________PARENT WORK #_____________________
BIRTHDATE_______________________SCHOOL ATTENDING____________________
PARENT’S SIGNATURE_______________________________________________________
All classes will be held at The International School,28555 Middlebelt Rd., Room 17, Farmington Hills, at the times specified below. Classes will be two hours in length (24 hrs total) with 6 hours of driving (to be scheduled with instructor). Transportation to and from class is the student’s responsibility. Apple Driving School Inc will provide all materials.


Please return this pre-registration form and contract with payment to Apple Driving School Inc. at the above address.

Please keep a copy for your records!
Please note: this will serve as your confirmation unless notified otherwise


4895 Stoddard Troy, MI 48085

(248) 689-8224 -


(Parent’s signature)

I, _________________________________________ agree to pay Apple Driving School Inc. (ADSI) $309.00 for a Segment One course in Driver’s Education. Additional driving may be purchased in advance of final drive or any time after successful completion of program for $50 per hour. Student is eligible for Segment Two after not less than 3 consecutive months with a Level One license. Apple Driving School will provide 24 hours of classroom experience, 6 hours of behind the wheel (BTW) training, and 4 hours of observation time. Classroom instruction must be a minimum of 3 weeks in length. BTW instruction shall not begin until the student has received a minimum of 4 hours of classroom instruction. BTW instruction must be completed no later than 3 weeks after the classroom instruction has been completed. All materials will be provided by ADSI. ADSI will provide full auto liability insurance while student is in our dual brake control cars. All ADSI instructors are certified by the Michigan Dept. of State to teach drivers education and have been fingerprinted by the FBI and Michigan State Police. Class must be paid for in full by the first day of class and may be paid by cash, check, or money order, or by credit card (on-line registration only). We reserve the right to hold the completion certificate until payment is received and/or a check clears the bank. There is a $35.00 fee for returned checks. There will be no refunds after the second day of class. All refund requests are to be made in writing and a $20 processing fee will be deducted from your refund. The processing fee will not be charged if ADSI cancels the class. There will be a $20 fee for non-returned or damaged books.

Driving time is scheduled between the instructor and student. It is the student’s responsibility to be at the appointed time and place for driving. There is a $25.00 no-show fee (paid by the student) if he/she does not show up on time for his/her driving appointment or has not given 24-hour minimum prior cancellation notice to ADSI or it’s instructors. This fee must be paid before the student will be rescheduled to drive.
Student must have 24 hours classroom and 6 hours BTW training, pass driving, and pass an 80 question state test with 70% or better grade before a certificate of completion will be issued. Student may not miss more than 4 classes (8 hours), which must be made up during the next scheduled program. There is a $25.00 fee for each make up class – to be paid when coming to make up class(s). Any student who misses more than 4 classes (8 hours) will be excused from the program. Student may retake the final exam (twice) during the next scheduled class (if necessary) at the $25.00 missed class fee. If student is tardy for class or driving, they are considered absent.
There is a $10.00 replacement fee for lost Segment One or Two certificates, or for record look-up. Please enclose payment at time of written request to above address.
Notice: This school is required to be licensed by the Michigan Dept. of State, Driver Programs Division, Provider certificate # P000398. If you have a complaint which you cannot settle with this school, WRITE: Michigan Dept. of State, Driver Programs Division, Lansing, MI 48918. Completion of driver training instruction does not guarantee qualification for a driver license.

(Please Print)

STUDENT LEGAL NAME_________________________________________________________________________________

(First) (Middle) (Last)

PARENT/LEGAL GUARDIAN ADDRESS________________________________________________________________________

(Street) (City) (Zip)
PHONE (parent or legal guardian)_______________________________BIRTHDATE___________________________________
DATES of CLASS_________________________________________________________________________________________
CLASSROOM LOCATION (address)_The International School, 28555 Middlebelt Rd, Farmington Hills_____________________
I hereby state that I have read and understand the above information and that student is at least 14 years and 8 months of age on or before the first day of class and will not reach 18 until after this program is completed. Student has no physical handicap or disability or takes no medications or drugs, which would impair or prevent them from driving a motor vehicle or would endanger the lives of others.


Student Signature Parent/Guardian Signature Date

Driving School Manager Signature Date

Please keep a copy for your records!

Apple Driving School Inc.


Please print

STUDENT FULL NAME: __________________________________________________________________

Last First Middle
ADDRESS: ____________________________________________CITY: ____________________________
ZIP CODE: ____________ HOME PHONE: __________________ CELL PHONE: ____________________
BIRTHDATE: _____________ AGE: (Years & Months) __________ (Verified by birth cert. copy we can keep)

Student must be at least 14 years and 8 months by the first day of class.
PARENT/GUARDIAN”S NAME: __________________________WORK PHONE: ___________________
EMERGENCY CONTACT: _______________________________ PHONE: _________________________

  1. Does the student require any special accommodations to participate in the classroom phase (i.e., test being read to him/her, an interpreter, seating arrangements, etc)? Yes ______ No ______

If yes, please explain: ______________________________________________________________

  1. Does the student require any special accommodations to participate in the behind-the-wheel phase (i.e. adaptive devices, an interpreter, etc.)? Yes ______ No ______

If yes, please explain: ______________________________________________________________

  1. Is the student taking any medications that may affect his/her ability to drive a motor vehicle safely? Yes ______ No ______ If yes, please describe: __________________________________________

  1. Are there any medical conditions that pose a concern with the student’s behind-the-wheel instruction (epilepsy, asthma, color blindness, hearing loss)?

Yes ______ No ______ If yes, please explain: __________________________________________

  1. Is the student’s visual acuity at least 20/40 corrected? Yes ______ No ______

  1. In the last six months, has the student had a fainting spell, blackout, seizure, or other uncontrolled loss of consciousness? Yes ______ No ______

  1. In the last 6 months, has the student had a physical or mental condition that affected his/her ability to drive a motor vehicle safely? Yes ______ No ______

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 the 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.




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