Shield Driving School
10109 Aurora Ave North, Seattle, WA 98133
(206)366-9111 | Fax: (206)366-9116 		 
Welcome to Shield Driving School
Dear student please complete steps 1 through 3 to signup for a classroom and have your seat reserved. Our web site is updated Real-Time so to assure accuracy of the information. Please make sure to include your email address because your enrollment confirmation will be sent there.
Package NamePackage DescriptionPriceSelect
DOL Knowledge Test $30.00

 
Student Information
Student First Name:  * Student Email:  *
Why we are asking for this?
Student Middle Name:   Home Phone:
Student Last Name:  *   Student Cell:  *
Address:  * How did you hear about us?:  *
City:  * Gender:  *
State and Zip:    * Permit or Confirmation #:
What is this?
Date Of Birth:      * Permit or Confirmation Issued Date:     Pick the Birth Date  
Parent/Guardian Name:    * Permit or Confirmation Expiration Date:   Pick the Birth Date  
Parent/Guardian Cell #    * Do you have any medical conditions that we should be aware of?    *
Parent/Guardian Email:    * Medical Condition Explanation:
High School:  *    
Wear Glasses/Contacts:
Coupon Code:      Special Needs:    
    Friend Referral Name:   
 
 
In order to enroll and confirm your seat in the class, a $100 deposit is required at the time of enrollment. To make this payment or to pay the package in full, please select the “Pay Now” option and select the amount you would like to pay from the “Payment Amount” drop down menu

I have read and agree to Shield Driving School's Policies and Procedures.

 
* - Required   
 



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