Driver’s Education Online ONLY – Madison, WI

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Invoice
Driver's Education Online ONLY - Madison Registration

Fun Village, LLC. DBA JUST DRIVE
P.O. Box 24
Port Washington, WI 53074
(262) 806-3880

This is an Online Classroom ONLY course for Teen Driver's Education. If you're interested in a Drive'rs Ed + Behind the Wheel package check our locations page for a location near you.
Student Information
Student Name*
First Middle Last
Student Email*
Enter Email Confirm Email
Student Address*
Street Address Address Line 2 City State ZIP Code
Student Phone*
Date of Birth*
Date Format: MM slash DD slash YYYY
Billing (Parent or Guardian) Information
Name*
First Last
Email*
Enter Email Confirm Email
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Student User Information
Username
Password*
Enter Password Confirm Password
Driver's Ed Online
Price: $99.00
Total
$0.00
Terms & Conditions
Just Drive will not refund any tuition or part of tuition if Just Drive is ready, willing, and able to fulfill its part of the agreement. Just Drive will not refund any tuition after a student has completed 5 sessions or 15 days after registration, whichever comes first.

This written agreement constitutes the entire agreement between Just Drive and the student/parent/guardian. No verbal statements or promises will be recognized.
Do you agree to the terms and conditions?*
- Yes I Agree
Student E-Signature (Full Name)*
Date:
Date Format: MM slash DD slash YYYY
Parent/Guardian E-Signature: Full Name*
Date:
Date Format: MM slash DD slash YYYY
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Comments
This field is for validation purposes and should be left unchanged.

Driver’s Education Online ONLY – Madison, WI

Driver's Education Online ONLY - Madison Registration

Student Information

Billing (Parent or Guardian) Information

Student User Information

Terms & Conditions