Student Information Sheet

Please clearly print all information

Fill in and mail or email this form to address below



DOWNLOAD Student Information Form

NAME(as printed on Learner's Permit)___________________________
ADDRESS_____________________________CITY_________ZIP______________
AGE_________BIRTHDATE____________________
SCHOOL_____________________________HOME/CELL#___________________

PARENT(S) NAME_____________________WORK/CELL#_______________

STUDENT DRIVER INFORMATION:
Which class are you registering for?_________________________
Learner Permit or Driver License#_____________________________
Hours of previous driving experience_________________________
Do you wear glasses and/or contacts?________________________
Do you have any handicaps?__________________________________
How did you hear about us? (Referral, internet, signs, school paper, other)
_________________________________________________________

Please mail or email this information sheet to:
Bobís Driving School Omaha .com
2209 So. 138th Street 68144
(email)g_bob47@hotmail.com
Omaha, NE 68144
Bring payment of $360 check, cash or money order to the first class.

Questions? Call 402-719-8269 or 402-333-3535