Metairie Saturday August 15th Road Skills Test
Certificate Number
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Appointment
*
Applicant's Name
*
First Name
Last Name
Applicant's Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent's Cell Phone Number
*
Enter 000-000-0000 if 18 and older
Format: (000) 000-0000.
Applicant or Parent's Email address
*
example@example.com
Applicant's Learner's or Temporary Instruction Permit Number
*
Check issue date to assure it has been 180 days from today.
Date Learner's or Temporary Instruction Permit was Issued
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Take a close up picture with just your Learner's Permit or Temporary Instruction Permit in the picture (just the card, not a picture of you). If submitting a Temporary Instruction Permit you must have envelope with documentation for a Learner's Permit and be at least 16 Years Old.
*
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Must be a minimum of 16 years old and have had your Learner's Permit for at least 180 days. If the Applicant is 17 the 180 day driving period is not required.
Parent's Name (Type NA if 18 or Older)
*
First Name
Last Name
License/ID No. of Parent/Guardian (Type NA if 18 or Older)
*
(Type NA if 18 or Older)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I understand that, to be eligible for testing, the applicant must be at least sixteen (16) years of age and must have held a valid Class E Learner's Permit for a minimum of one hundred eighty (180) days on the date of the test.I understand that the Road Skills Test deposit is NON-REFUNDABLE and that Road Skills Tests will not be rescheduled for any reason.I understand that if I am not present at the office at least ten (10) minutes prior to my scheduled appointment time, my appointment will be canceled and my deposit will be forfeited.I understand that if the applicant is seventeen (17) years of age or younger, a parent or legal guardian must accompany the applicant to the appointment.I understand that the total cost of the Road Skills Test is One Hundred Dollars ($100.00), which consists of:Forty Dollars ($40.00) for the Road Skills Test; andSixty Dollars ($60.00) for the use of the vehicle.I understand that the $40.00 deposit is applied toward the total cost and that the remaining $60.00 must be paid in cash at the time of testing.I understand that if I am upgrading directly from a Temporary Instruction Permit, I must have earned a Driver's Assessment score of at least eighty percent (80%) on my Certificate of Completion in order to be eligible to take the Road Skills Test.
*
Yes I Agree
My Products
*
prev
next
( X )
Non Refundable Road Skills Test Deposit
Non Refundable Road Skills Deposit. The remaining Balance is $40.00 cash only.
$40.00
$
40.00
Preview PDF
Submit
Payment Methods
Debit or Credit Card
Buy with
Buy with
Should be Empty: