-

Legal Name *

(No nicknames, abbreviations, etc.)

Middle Initial

Last Name *

Address *

City *

Zip *

Date of Birth *

Gender *

---MALEFEMALE

Home Phone *

Parent/Guardian Mobile *

Work/Other Phone

Parent/Guardian Email Address *

Permit ID# *

Required upon registration (9 digits)

High School you attend *

---CalhounKennedyMepham

If Guardian Last Name is different please enter here

SCHEDULES WILL NOT BE E-MAILED

Students must access his/her schedule online January 5, 2021 @ 10:00 a.m.

http://www.bellmore-merrick.k12.ny.us/schools/drivers_education

Schedule changes will not be permitted.

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

*** Refund requests must be submitted by January 8th before MIDNIGHT ***

In addition, every student, and a parent/guardian must attend one of the 3 evening meetings of "Driving in the Safe Lane," presented by the Bellmore-Merrick Community Parent Center. This meeting will be done remotely or in person with limited capacity. All meetings will be held virtually using the Zoom platform. Dates and times will be determined.

Car Times *

---6:00 a.m.2:30 p.m.4:00 p.m.Saturday @ MephamSunday @ CalhounSunday @ Kennedy

Special Requests LIST PREFERENCES BY ORDER OF IMPORTANCE

List in order of importance. (car pool requests, block out days etc.)

Lecture Classes *

---JFK TuesdayCalhoun ThursdayMepham WednesdayMepham Saturday

Lecture Times *

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

Registration and preferences are subject to availability of fleet and are not guaranteed:

Car Classes: 7:00 AM, 8:30 AM, 10:00 AM, or 11:30 AM

LECTURE CLASSES - 7:15 AM, or 8:45 AM

********ALL INSTRUCTION TAKES PLACE AT CALHOUN HIGH SCHOOL.********

 SCHEDULE POSTINGS:

 Students must use this link https://www.bellmore-merrick.k12.ny.us/driver-education-home to access their schedule online on June 12th, 2025. Requests for refunds or schedule changes must be by email to: tmalloy@bellmore-merrick.k12.ny.us   by 2:00 PM June 23, 2025. 

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 will be posted by 12:00 PM on June 12, 2025.

******** Refund requests must be submitted by June 23, 2025 before 2 pm ********

IMPORTANT INFORMATION...READ BELOW

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 student and I hereby grant permission for him/her to enroll in the Bellmore-Merrick CHSD Driver Education Program. I have read and understand the schedule portion, refund policy & student obligations explained in this form.

Parent or Legal Guardian Signature *