OHIO DEPARTMENT OF PUBLIC SAFETY

TRAINING AGREEMENT

ENTERPRISENAME ��しICENSENUMBER

Maste「&SyivaniaDrivingSchool‘ ��622

CUISSROOMADDRESS �CI丁Y ��STATE �ZIPCODE

Name of Ente「p「ise, hereina債er refe「「ed to as “The D「iving SchooI調agrees to provide applicant, hereinafte「 referred to as“Student’’, 24 hou「S Of cIass「oom instruction and 8 hou「S Of practica同「iving inst「uction based on the Ohio D「ive「 Training

Cu「「icuIum. State of Ohio reguIations requi「e The Driving Schooi to make avaiIabIe a= t「aining by

ShouId a student be unabie to attend avaiIabIe training sessions offered, the schoo=s reIieved of the aforementioned

ObIigation. Reguiations p「Ohibit more than fou「 hou「s of training to be conducted in one day. The D「iving SchooI sha=

fumish a licensed instructo「 and a moto「 vehicie fo「 instruction. The tuition fo「 said inst田Ction is $

Any additional cIassroom training that the Student chooses to procure sha= be fumished at the 「ate of $ 40,00　　pe「

hou「・ Additiona=n-ca「 training may be obtained at the ho両y 「ate of $ 40.00　. Student, uPOn the approval of The

D「iving SchooI, may, fo「 an additionai fee of $ 40.00　　use the D「iving School’s vehicIe to take a driving exam at a

State exam center Iocated in County, OH.

The D面ng School may loan the Student a textbook fo「 use du血g enro=ment at肌e D「iving Schooi. A fee of $ 20,00

wi= be charged fo「 any book not retumed o「 retumed damaged,

The Student may begin classroon instruction, at age 15 years and 5 months, before obtaining a temporary driving pemit.

Howeve「・ the Student is required to obtaln a vaIid temporary d面ng pemit a=d pay tuitien in仙I prio「 to scheduling伽e

PraCticaI driving portion of仙e training. 1f the Stude巾must cancel a scheduIed d面ng appointment, cance=ation must be

made before a minimum of塾_ hou「S Prio「 to the sched山ed appointment, Faiiure to do so may resu旧n an additional fee

of$ 10.00 De「 hou「　　　　" The same fee shaIl appiy shouid the Sfudent fail to appea「fo「, O「fo「 any reaso掴Ot be

PrePared to take, the scheduIed lesson. The D「M=g Schooi 「eserves the right to deny伽e Student admittance to any cfass

if the S山dent is tardy・ Shou旧a check received as payment of tuition in whole o「 in pa巾be refumed due to insu簡cient

funds, the Student may be removed from d面ng scheduIe until such check is made good. An add師Onal fee may be

Charged fo「 any retumed check.

The Student is required to complete a= availabIe training w帆n six mon仙S Of the date the什aining begins. There may be

no refunds provided afte「 thg輔me. Upon expiration of仙s ag「eement, a reinstatement fee may be cha喝ed before any

fu甜Ie「 Services are provided. The D画ng School does not guarantee the issuan∞ Of a drive「s Iieense to the s山dent. 1f

training is not ∞mPleted w柵n the six months, a neW agreement Sha= be established and training sha= be restarted.

The D「iving School reserves the right to can∞I帥S ag「eement at any time, ShouId仙e Student’s conduct indicate a Iack of

respons酬fty deemed necessary by The D面ng SchooI to safety operate a moto「 vehicle, Dest田Ctien of property, O「 the

POSSeSSien, dis帥bution, O「 uSe Of any tobac∞ Product, aIcohol, 0「 drug of abuse is s帥ctly prohibited. Should this

ag「eement be canoe帖d unde「 such circumstances, ali fees may be pro-rated, based upon hou「s of services provided

Prio「 to canceliation,

Refund Poiiey:印ere is ro refund as Iong as Master & SyIvania Driving Sch∞=s w冊=g and abie to fu剛its part of仙e

agreement, NO REFUND sha= be made fo「 any reason.

The D「iving Sch∞i sh訓fumish a oert綱cate of completien to a= students unde「 the age of eighteen years, Who

SuCCeSS軸Iy complete the ∞u「se・ CompIetidn, as defined by the State of Ohio, refers to the ∞mPletion of伽e required

number of hours' the student’s good fa軸effort haIVi=g been exercised du血g the practit冶i driving portion, and the

attainment of a score equai to or g「eate「 than 75% on肌e perfemance measurement. ShouId Student faii to achieve the

m面mum passing score on the finaI exam additio=aI cIassroom atte=dan∞ may be 「equired.

Commerciai D「Mng sch∞is are lieensed by the Depa巾T`ent Of Pu馴ie Safety through the Drive「 Training Program O緬ce,

1970 West Broad Street' CoIumbus' Ohio 43223. Vaiuable infomation fo「 parents and tee=age「S is avaiIabie on the

intemet at www.伽Ve巾aininQ.Ohie,00V; unde「 Parents and Teens.

i have read and understand and have re∞ived a ∞Py Of仙is agreemenし

SCHOOLOFFICIAL ��濁蹴器署:一札額紅ブ �DATE Barba「aHughes

STUDENT �STUDENTDOB �‡UDENTS’GNATURE　　O �DATE

PARENT/GUARDiAN ��PARENT/GUARDIANSIGNATURE �DA丁巨

X

D丁0 0141 7I14 1760-1275】

OHiO DEPARTMENT OF PUBLiC SAFETY

STUDENT C」ASSROOIVI TRAINING REPORT

The most cu「冒ent ve誌ion of this document available at www.drivert輪inin〇〇〇hio.qov

SCHOOしNAME

Maste「&SyIvaniaDrivingSchool

STUDENTNAME ��DATEOFBIRTH �PHON宣撫

ADDRESS ���ZIPCODE

PERMiT# �DATEISSUED �Cリ1SSSTARTDATE �CIASSENDDATE

DA丁巨 �START �END �Ac血a重 Timef �OHUN!丁 �丁O丁A」 �ViDEOTIME ��CI」ISS �STUDENT �INSTRUCTOR �lNSTRUCTOR 丁iM巨 �丁iM巨 �　0 Break �NUMBER �丁iM巨 �HOURS/MINUTES ��しOCATION �INiTIALS �INIT!ALS �LICENSE NUMBER

FINAL TEST PERCENTAGE

%

iNSTRUCTOR PRINTED NAME

i, the undersigned Instructo「 O「 T「aining Manager, CeI巾fy that the student named above has received a= ciass「oom t「aining

「equired by Rule 4501-7-09 of the Ohio Administrative Code (O・A.C.)" The student has aIso received aII classroom t「aining

required and 4508.02 (C) of the Ohio Revised Code. This tra面ng included at Ieast 24 hou「s, and covered units l-10 of the

Ohio D「ive「 T「aining Cu「「icuIum. This cou「se must be compIeted within 180 days f「om you「 start date.

美G胴EOF’NSTRUCTORORT剛NGVARAG駅　屋〆&届少。_葛_ ′　　　　　　　　　　　′

10 Ohio Curriculum Units

1.TheSystemandYou　　　　　　　　　　　　　　　6.NaturaILawsAifectingVehicIes

2・VehicleFamiIia「ization　　　　　　　　　　　　　　7・HandIingEme「gencies

3"　BasicCont「oITasks　　　　　　　　　　　　　　　8.OperatinginAdve「seConditions

4.Tra簡cCont「oIDevicesandLaws　　　　　　　　　　　　9.D「ive「Fitness

5・St「ategiesfo「Diffe「entEnvironments　　　　　　　　lO.OwningandMaintainingaCa「

No pe「son shali falsify' aIte「・ O「 in any manner tampe「 with any records required to be kept by the O.A.C"

Breaks: Pe「 O.A.C・ 4501-7-09 (B)(3) The totai training a student 「eceived sha冊Ot eXCeed fou「 hou「s in one day. Students

recelVIng mOre than two continuous hou「s of training shalI be pe「mitted a b「eak at the app「oximate mid-POint of the Iesson.

D丁0 0138 〃14 【760-1275i

OHIO DEPARTMENT OF PUBLIC SAFETY

STUDENT BEHIND-THEWHEEし

TRAINING REPORT CLASS D

The most cu町ent VeTSion of this document availabIe at wwwdivertrainina,Ohio血oV

STUDENTNAME �DATEOFBIRTH �HOMEPHONE♯ �WORKPHONE#

ADDRESS ��S丁A丁と �ZIP

PERMiT#/DRIVERLiCENSE# ��DATEISSUED �EXPIRATIONDATE

ENTERPRiSENAIME ��ENTERPRISE# �REPORTYEAR

Maste「&SyivaniaD「ivingSchool ��622 �2017

NOTE:B �reaktimedoesnotcounttowardthe8hoursofre ������uiredinst「uctio ���naltjme.

STARTDATE �����∈ �望 董 曾 こi �の こ .9 電 墨 ⊂ の こ) e 嘗 コ ⊂ 萱 .あ �の 登 .雲’ ⊂ 」こ 8 �き くこ く二 重 ○○ 電 ⊂ 烏 ’⊂) �l二 毒 �>ヽ 呈 .里) .⊂ 謹 くo 母 も �重 き 宣 誓 。 (こ の � �o 焉 �宣 .重書 邑 (こ �○ ○か (二 くロ .章二 �くカ ⊂ 電 �⊂n � � �CERTIFICATE lSSUED □YESロNO

NUMBERISSUED DATEISSUED

豊 星 空 ● �官 憲 ��⊂か ⊂ 毒 筆 �差 ⊂D 一石i くの 富 �.王 室 烏 �書 8 豪 �= くり 各 署 調 合」 奄 �雀 の 容 ≧・ �.さ ち ぎ =) 妾 �〇 号 ぎ :… てタ ������

BEHINDTHEWHEELTRAiNING PERFORMANCECODE ���������������������

DA丁E �S皿R† 丁iM巨 �BR臥K 丁IM巨 �ENDTIME �HOJRS DRIVEN �意 ,重こ く⊃ �言 l山 �.⊆ lこ 萎 �辱 二面 くの �の 重= ⊂か 董 �o 8 茎 �空 言 �毒 告 �盲 二) ○ ○ �善 書 �孟 夏 �○ q) `= ぶ �章_ C) (ヱ (と �iこ 登 ���lNITiALS/ しiC巨NSE# �lNiTIALS

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=he undersigned lnst軸cto「, Certfty that the Student has satisfactoriIy Optionai:

認諾器詣請晋探鳥謹誓uired by thlS Chapte「　藍豊警落露盤託霊㌣岩盤詰豊島。h,,。.SIGNATURE OF INSTRUCTOR

X

SIGNATURE OF PARENT / GUARDIAN

X

No pe「SOn ShaII falsfty, a!te「 o「 in any manne「 tampe「 with any records required to be kept by the Ohio Administrative Code.

DTO O137 7/14 [760-1275i

OHIO DEPARTMENT OF PUBLIC SAFETY

STUDENT BEHiND-THE。WHEEし

TRAIN看NG REPORT C」ASS D

The most cument version of請is docume巾ava帥able at ww.d凧Iert輪inin〇〇〇hio.〇OV

門島醗輯閑古描了畔も

STUDENTNAME �DATEOFBIRTH �HOMEPHONE# �WORKPHONE♯

ADDRESS ��S丁A丁巨 �ZiP

PERMiT#/DRIVERLiCENSE# ��DATEISSUED �EXPIRA丁IONDATE

EN丁ERPRiSENAME ��ENTERPRISE# �REPORTYEAR

Maste「&SyIvaniaDrivingSchooi ��622 �2017

oeSnOtCOunttoWardthe8hoursofreq �������uiredinst調Ctio ���naitime.

STARTDATE �����;!雪 害 �登 聖 二) �登 .9 萱 の 量 `) ∈ �∽ 当 .里‾ こ 霊 �⊂n .⊆ 〔こ l二 くり 百〇 嘗 忍 “!ブ �毒 �雪 .望) .重二 の 蟹 の 竜 も �蔓 圭 」さ 、 掌 二つ の こ くo � �罵 �宣 .くさ 邑 ⊂: �⑲ 亡の こ くロ 」= �亡の 各 務 ° �にか � � �CERTIFICATE ISSU巨D □Y巨S□NO

NUMBERISSUED DATEISSUED

BEHiND"THEWHE重しTRAINING 　PERFORMANCECODE �����豊 で) 箪 ●._ ● �1ブ 豊 富 �こl !二 萱 「売 �なか ⊂ 琶 邑 望 �.合 音 魯 �⊂ 萱 駕 �富 家 �雪 ぎ 名 望 で �(0 雪 と・ �.さ る 筈 こ) 雲 �q) き くか 重こ 一三 等 ������

DATE �S鵬R丁 丁iME �BR巨AK 丁IM巨 �ENDTIME �HOURS DRN巨N �重 くj �主 な ○○ �.⊆ 亡 妻 �電 で くの �の 」二 〇) 董 �o 雪 �空 言 �垂 蜜 �こ き �董 j �圭; .!∋ 之 �○ ○) (= ぶ �くつ くと は �仁 の 聾 ���INiTIA」Sl LiCENSE# �DENT lNiTIAしS

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I, the undersigned lnstructor, Certify that the Student has satisfacto刑y Optional:

認諾書誌討詔認諾諾書red by this chapte「　蕊蒜窯嘉蔀請託盈終盤詰罵:ny 。hi,。.SIGNATURE OF INSTRUCTOR

X

SIGNIATURE OF PARENT / GUARDiAN

X

No pe「son shaII falsfty, aite「 o「 in any manne「 tampe「 with any re∞rds required to be kept by the Ohio Administrative Code,

D丁0 0137 7114け60・1275I

OHIO DEPARTMENT OF PUBLIC SAFETY

FiNAL REPORT TO PARENT

The most cument v○○sion of this document availabIe at www,d「ivertrainina.ohi○○aov.

The enterprise o「 Organ軸On帥at compIeted the training fo「 three yea「s sha= maintain records of the inst田ctOrs and

training manage「s trained. Dates, times, location of training, and cu巾culum used sha看i be kept on冊e fo「 inspection. No

Pe「SOn Sha= falsify, aife「, or in any ma…e「 tamPe「 W軸any reoo「ds 「equired to be maintained.相re∞rds requi「ed to be

maintalned by an enterprise under the Ohio Administrative Code (O.A.C.), including those maintained on a compute「

database, Sha= be kept in a school’s designated o飾∞. The autho「izing o怖ciaI o「 training manage「 sha= make all records

avaiiable fo「 inspection by the directo「 o「 by a s山dent and I o「 the stndentls parent o「 legal guardian at any and all

reasonabie times. Any records requi「ed to be maintained which are in a ∞mPute「 database shalI be accessible and

CaPable of being dis帥guished from non-re厄ted 「ecords.

REPORTYEAR �ENTERPRISENAME ��ENTERPRISE#

2017 �Maste「&SyIvaniaD面ngSchooI ��622

STUDENTNAME

CERTIFICATEOFCOMP」ETION# ��DATEISSUED

StudenthasreceivedaIIclass「oom/OnIineinstruction「equi「edbyO・A.C.4501-7-09andOhioRevisedCode

(R・C.)section4508.02(C).　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　□ ★Note:Studentswhoreceivedoniineinst「uctionprovidedp「oofcompIiantwithOAC4501-7-11

謹諾霊諜薄COmPIetedthebehind‾thew圃nst「uctionrec申「edbyO.A・C"4501‾7‾10and　　□

Studenthasreceivedascoreonanyexaminationofknowiedgeo「sk冊equiredbyO,A.C.4501-7-09.　　　　　□

%(KnowiedgeTestScore) Studenthas「ecejvedafinaltestscore・青Note:SCOrenOtaVaiIabIeforstudentwhocompIetedonIineinst則Ction　□

The∞mPletedandsignedtraining「ecordhasbeengiventothestudentuponcompletionofthetraining,　　　　□

I, the unde「Signed lnst「ucto「 o「 T「aining Manage「, Autho「izing O鞘ciaI ce巾fy that a旧raining has been

SuCCeSSfuily compieted ,

芸STRUCTOROR酬NGMANAGERSIGNATURE　4生唾- �DA丁各

REMARKS:

DTO O143 7/14 F60-1275]