BMCHSD DRIVER EDUCATION PROGRAM

Legal Name *

(No nicknames, abbreviations, etc.)

Middle Initial

Last Name *

Address *

City *

Zip *

Date of Birth *

Gender *

--- MALE FEMALE

Home Phone *

Parent/Guardian Mobile *

Work/Other Phone

Parent/Guardian Email Address *

DMV Permit ID# *

High School you attend *

Name of High School you atttend or would attend (private school students select your district home school)

--- Calhoun Kennedy Mepham

If Guardian Last Name is different please enter here

SCHEDULE POSTINGS

Students must use this link http://www.bellmore-merrick.k12.ny.us/schools/drivers_education to access their schedule online on Wednesday September 11, 2019.

Schedule change requests must be submitted by Friday, September 13th to: adalessandro@bellmore-merrick.k12.ny.us

Phone calls to the district regarding schedule changes will not be accepted.

Students must refer to the website for changes, cancellations and/or updates.

Final Schedule posting will be on Monday, September 16, 2019.

*** Refund requests must be submitted before MIDNIGHT September 16th ***

CAR Class Times *

--- 6:00 a.m. 2:30 p.m. 4:00 p.m. Saturday @ Mepham Sunday @ Calhoun Sunday @ Kennedy

Special Requests LIST PREFERENCES BY ORDER OF IMPORTANCE

Lecture Class Location *

--- JFK Tuesday Calhoun Thursday Mepham Wednesday Mepham Saturday

LECTURE Class Times *

Saturday Lecture and Car Classes @ Mepham.
Sunday ONLY Car Classes @ Calhoun & Kennedy.

--- 3:30 p.m. 5:00 p.m. 6:30 p.m. Saturday @ Mepham

Program Location:

Registration and preferences are subject to availability of fleet and are not guaranteed.
Students attend one car and one lecture class per week, each class is 90 minutes.
Please make your selection
Car Days: will be assigned by the District

Important Information

Drivers Education Mission Statement

The Bellmore-Merrick Central High School District Driver Education is committed to excellence. The program is offered only to residents of Bellmore and Merrick. The Driver Education course is intended to educate students (age 16 or older) on appropriate driving skills and habits as well as playing a responsible role in the highway transportation/safety system. Course highlights include 24 hours of classroom instruction and 24 hours of behind the wheel training and observation. Students who satisfactorily complete the course are eligible to receive the MV-285: Student Certificate of Completion. The MV-285 Student Certificate of Completion allows:

1. a NYS Junior Permit holder to schedule a road test
2. young drivers a possible reduction in automobile insurance cost (dependent upon insurance provider participation)
3. a 17 year old to receive a senior license (MV-285 form must be submitted to local DMV to attain this benefit) DMV MV-278 (5 Hour cards) MAY be issued by the Lecture Teacher during the course, IF available and time permits.

Refund Policy

All refunds must be requested by email addressed to adalessandro@bellmore-merrick.k12.ny.us If a student cannot be accommodated because classes are filled, all monies will be refunded. If a student makes a schedule change request on the specified date and cannot be accommodated, all monies will be refunded. Tuition refunds will be granted on the final posting date, BEFORE MIDNIGHT. There will be no exceptions.

Absences

A student is allowed to make up to 3 absences in either car or lecture class. All absences must be made up. More than 3 absences in either class (not combined) will result in the student failing the course. There are no "excused" absences. Absences due to sports, SATs, ACTs (or other exams), are still considered absences.

Make-Ups

Make-ups classes will be arranged directly with the lecture teacher and/or car instructor. If you are absent, you should speak with your instructor at the next class that you attend.

Student Obligation

1) I will always obey all New York State vehicle and traffic laws.

2) I understand that I must successfully complete both the road and theory portions of the course in order to receive        Certificate of Completion aka MV-285.

3) I will conduct myself in a responsible manner at all times in both car and lecture classes.

4) I understand that all cell phones must be turned OFF during car and lecture classes.

5) I understand the Absence/Make-up section of this application.

6) I understand that in order to take advantage of the road portion of the course, I must gain additional practice time        with my parent/legal guardian during approved hours.

7) I understand that 50 hours of parent supervised instruction is required when applying for a license under the age of      18. (MV-262 is also required at the road test.)

8) In the event of a collision during the conduct of the car class, I will give a full and detailed statement to the driving        school regarding that collision.

9) I will carry my Lerner’s Permit and High School I.D. at all times, and present it when requested.

If it is determined that a student is impaired in anyway, they will be asked to leave the        class which will result in consequences, as per the district student code of conduct policy.

Student Signature *

Mandated Meeting

 

Every student, and a parent/guardian must attend one of the two evening meetings of
"Driving in the Safe Lane," presented by the Bellmore-Merrick Community Parent Center.

 Date/Time will be determined

Parental/Guardian Consent

I hereby certify that I am the parent or legal guardian of the above named student, and I hereby grant permission for him/her to enroll in the Bellmore-Merrick CHSD Driver Education Program and I read and understand the schedule portion, refund policy & student obligations explained in this form.

Parent or Legal Guardian Signature *