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Segment 2 Contract

Program Information

Classroom Location:
Program #:
Start Date:
End Date:

Student Information

Date of Birth:
Please include city, state, and zip code in the address field.
Parent/Guardian Cell:
Student Cell:
Parent Address:
Same as student address?

Level One License

This is not the same as your segment 1 certificate.
License Number:
Issue Date:


Advanced Driving Academy will provide each student the following:

  • Six hours of classroom instruction
  • Classroom instruction materials

Class Details:

  • Classroom instruction takes place over three days, exceeding no more than two hours per day.
  • The Student must bring their Level One Learner's License and driving log to the first day of class.

Terms and Conditions

  1. A minimum of 30 hours of supervised driving, including two hours of nighttime driving, on a Level 1 license that has been held for at least three continuous months must be completed before a student can be accepted into Segment 2. Supervised driving is defined as driving with a licensed parent, guardian or parent designee age 21 or older.
  2. The parent/guardian agrees to pay the amount of $60 at the time of registration. We only accept cash or credit card.
  3. The required score to pass the 20 question State Test is 70%.
  4. The student must make up any class time missed. All make-up sessions must be completed no later than 3 weeks from the final class date.
  5. Students who miss more than one class session will have to retake the course at their own expense and will not receive a refund.

ADA Policies

  • A refund will be given, minus a $25 service fee, if the order is cancelled at least three days before the class has begun.
  • Students who miss, reschedule, or are late to a class session are subject to a $25 fee.
Notice: This driver education provider is required to be certified by the Secretary of State. If you have any complaint that cannot be settled with the provider, please complete the Driver Education Complaint form found under Driver Programs Division on the Department of State website: Completing driver education does not guarantee a driver's license.
Date of Contract:
I agree to the Terms & Conditions