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2 Hour Practice Drive and Test

2 Hour Practice Drive and State Road Test (One Free Re-Test included if needed - non-transferable)

Meet at designated Testing Location

[Near the conclusion of the 2 hour lesson the instructor will inform the customer if it is advisable for the student to test, however, if in the instructor's option the customer is not prepared to safely pass the State Road Test the test appointment will be cancelled. Then the customer will be able to purchase an additional 2 hour BTW Individual Lesson for $140 (a $20 discount off the retail price) and will be rescheduled for another date.]

State Road Test is $25, Use of Cowboy Driving Academy car $70 (Included)

>>>Student takes state road test by appointment and MUST possess a VALID PERMIT

***NO REFUNDS ONCE PURCHASED

$295.00

Student Information
First Name:	*	How Did You Hear About Us:	*
Middle Name:		Parent/Guardian Name (Teen Only):
Last Name:	*	Parent/Guardian Email (Teen Only):
Address:	*	Parent/Guardian Phone (Teen Only):
City:	*	High School Grade Level:	*
State and Zip:	*	Emergency Name:
Date Of Birth:	*	Emergency Phone:
Student Email:	*	Emergency Relationship:
Home Phone:	*	Drivers License/Permit Number:
Student Cell:	*	Drivers License/Permit Issued Date:
Gender:	*	Name of friend referring (if applicable):		Preferred Pickup Location:	*
High School (Teen Only):		Do you have a discount coupon?Enter code:		Preferred Pickup Day:	*
Apartment #:				Preferred Pickup Time:	*
Wear Glasses/Contacts:	*	Parent Other Phone (Teen Only):
		Drivers License/Pemit Expiration Date:

I have read and agree to Cowboy Driving Academy’s Contract and Agreement

* - Required