Driving In A New America, Inc
www.DIANAschool.com

REGISTRATION FORM:

Highlighted fields are required.
Student Name:
First:
Last:
Gender:
Primary Phone:
Alternate Phone #1:
Alternate Phone #2:
For emergencies only
Email Address:
Alternate Email:
Student Address:
Street and number:
Address Line 2:
City:
State:
Zip Code:
Last Four of SSN:
***-**-
Driver ID Number:
(Found on Driver's License or Learner's Permit)
Student Birth Date:
Test Eligibility Date:
(Found on Learner's Permit; Not required if over 18 or licensed)
Driving Experience:
Behind the Wheel:
Behind-the-Wheel Driving Packages
All lessons are conducted in 3 hour increments unless a special needs case exists.
1-Hour Driving Evaluation. Here's what we'll cover.
$125

If you wish to register for more than one 2-hour appointment, please register for ONE right here, and then phone our office to add the additional lessons.
$200($100 / hr)

$285($95 / hr)

$540($90 / hr)

Driving Test Packages
Final appointment includes Refresher Lesson and PennDOT Driving Test (details)
$765($85 / hr)


$1125($75 / hr)

$1260($70 / hr)

$1950($65 / hr)

NOTE: By electing a test package, you are permitting D.I.A.N.A. to act as your agent for the purposes of scheduling, rescheduling or canceling the PennDOT driving test for your student. Please do not schedule the test yourself, as it may not match up with our instructors' schedule. If you decide to cancel the test appointment with D.I.A.N.A., then, for your convenience, the PennDOT test will also automatically be cancelled.
Certain geographic restrictions may apply for free pickup. Packages can only be chosen upon initial purchase. You can always add additional lessons after the initial purchase, but the regular lesson price would then apply.
We allot 3-hours for this final appointment, but if PennDOT is behind schedule it may take longer, in which case we will not bill the client for the additional time. We also do not offer a refund if this appointment is under 3 hours. All lessons must be completed within one year of registration.
Comments/Questions:
Order Total:
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After you submit this registration form, please check your E-mail for your Invoice and instructions. We will then phone you to schedule appointments within 36 hours of receiving the tuition payment.