The Defensive Driving Academy

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Student Information

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First Name

Last Name

Birthday

Phone

Driving Experience

Permit Information

If you do not have a permit, enter placeholder information such as TBD for the permit number, 10/10/2018 for the issue date, and 10/10/2030 for the expiration date.

Permit Number

Permit Issue Date

Permit Expiration Date

Student Address

Street

City

State

Zip

Guardian Information (optional)

First Name

Last Name

Phone

Billing Address

Same as Home Address?

Street

City

State

Zip

Card Information

Name on Card

Card Number

Expiration Month

Expiration Year

CVC

Behind the Wheel Training

Driving Lessons & More

All Of Our Products

TotalGold - 4 Two Hour Teen Lessons + Free License Testing

$699

Adult Triple Play - 3 Two Hour Adult Driving Lessons

$399

Adult Addon - 1 Additional 2 Hour Adult Driving Lesson - Must complete Adult Consult first

$140

TeenTouchup - 1 Additional Two Hour Teen Lesson - Must complete 6 or 8 Hour DDA Program first

$150

Fender-Bender - 1 Two Hour After-License Lesson & Assessment

$149

Drive & Breathe - 1 Two Hour After-License Lesson & Assessment

$149

After-License6 - 3 Two Hour Lessons or 2 Three Hour Lessons

$399

After-License2 - 1 Two Hour After-License Lesson & Assessment

$140

Au Pair Aware - 1 Two Hour Adult Lesson & Evaluation

$140

Senior 2 Hour Tune-Up - 1 Two Hour Senior Lesson & Assessment

$99

Teen Testprep - 1 Two Hour Teen Testprep Lesson, Coach, Car + Free License Testing

$199

TestElite - 3 Two Hour Teen Lessons + Free License Testing

$599

CertSilver - 3 Two Hour Teen Lessons + No License Testing

$475

Adult Consult - 1 Two Hour Adult Lesson & Evaluation

$140

Adult Testprep - 1 Two Hour Adult Testprep Lesson, Coach, Car + Free License Testing

$199

Senior DMV Test Prep - 1 Two Hour Senior Test Prep Lesson

$99

Student Address