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Five Stars DS – Bronze 📍 146 Whetstone Crescent, Ottawa, ON K2G 7C3, Canada 📞 +1 613-890-2482
First Name
Last Name
Street number and Street Name / Apt or Unit #
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Telephone #1
Telephone #2
Driver's Licence #
Licence Expiry
MM slash DD slash YYYY
Email Address (certification will be emailed here)
Course / Payment Details
Package
Class Type
Online Classes
Virtual Classes
Transmission
Automatic (10 hrs)
Manual (12 hrs)
Theory Test
Theory Test 20
Theory Test 30
Course Fee ($)
Receipt #
Total Theory Mark
In-Car Marks
Terms & Certification I certify that the statements in this document are accurate and consent to the release of any information contained herein to the Ministry of Transportation, Insurance Bureau, and the MTO Course Inspector. To be CERTIFIED: you must successfully complete the entire course, consisting of 20 hours of theory and 10 hours of driving. This includes passing your theory tests, your driving evaluation, and completing your Student Workbook. To CANCEL A DRIVING LESSON, please notify your instructor 24 hours in advance. If you miss a lesson or cancel late, you will be charged $30.00. You have 6 months to complete your course.
Your course expires:
MM slash DD slash YYYY
I have read and understood the above contractual terms and conditions, I agree to abide by them.
(Required)
I have read and understood the above contractual terms and conditions, I agree to abide by them.
(Required)
Terms & Certification
(Required)
1. I certify that the statements in this document are accurate and consent to the release of any information contained herein to the Ministry of Transportation, Insurance Bureau, and the MTO Course Inspector.
2. To be CERTIFIED: you must successfully complete the entire course, consisting of 20 hours of theory and 10 hours of driving. This includes passing your theory tests, your driving evaluation, and completing your Student Workbook.
3. To CANCEL A DRIVING LESSON, please notify your instructor 24 hours in advance. If you miss a lesson or cancel late, you will be charged $40.00.
4. You have 6 months to complete your course.
(Required)
Signature
(Required)
Date
MM slash DD slash YYYY
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