READ THIS FIRSTTexas Supplement to

Help for the TeenagerWho Wants to Drive

Online Program

STEP BY STEP GUIDEFor Approved Course 102

State of Texas

These details address the unique and special driver education requirements for the State of Texas Department of Public Safety

A FORMAL, PARENT-CERTIFIED, PARENT TAUGHT DRIVER EDUCATION COURSE

Revised 7/31/17

Dear Valued Customer,

Thank you for choosing our program, “Help for the Teenager Who Wants to Drive.” You have just purchased the finest, and most complete, driver education and training program available in the country.

We consider it an honor that you have chosen us to help you teach your teen how to drive. Our program will give them the structure, discipline, and skills to truly become a Safe Driver For Life.

Please review this guide before you begin this course. The following are the contents of this package:

• Quick Reference Checklist • Detailed Texas Supplement Step-by-Step Guide • DL 91A instruction page• DL 91B Instruction Page• Additional DPS forms

Texas has strict rules that govern Parent-Taught Driver Education. Before you begin the course, please verify that the intended instructor is eligible to teach under Texas rules. In accordance with our refund policy, we can not issue a refund after 15 days or after permit qualifying documentation has been issued--even if the instructor is found to be ineligible to teach. According to Texas form DL 92, eligibility requirements include:

• Student must be 14 years of age prior to beginning the classroom portion, however they may not test for an instruction permit until their 15th birthday and must complete the entire program prior to their 18th birthday.

• Instructor must be the student’s parent, step-parent, grandparent, step-grandparent, foster parent or legal guardian appointed by a court of competent jurisdiction. A power of attorney is not legally sufficient.

• The instructor must have a valid driver license for the preceding three years; or if active military personnel or spouse, a valid driver license from state of permanent residency or last duty station for the preceding three years.

• The instructor cannot have a conviction (including a probated sentence) of criminally negligent homicide or driving while intoxi-cated. In addition, the instructor must not have had their driving privileges suspended, revoked or forfeited for traffic related viola-tions in the past three years. It is the responsibility of the instructor to check both their criminal or driver records prior to requesting the packet. The Department will check the instructor’s record at the time of processing the student’s instruction permit and also at the time of processing the student’s provisional driver license. If at that time, it is determined that the instructor does not meet the requirements, the instruction permit or provisional driver license will be denied and all prior classroom instruction or behind the wheel/in car instruction provided by the ineligible instructor will be invalid.

• The instructor may not be disabled due to mental illness. Questions as to mental stability will be forwarded to the Medical Advisory Board for determination.

As you work through our program and the licensing process, we welcome your calls anytime on whatever issue or question may arise @ 1-800-942-2050 (voice only). Again, thank you for choosing our program.

Sincerely,

The Entire Staff at National Driver Training Inc.

1901 Ranch Road 620 NLakeway, TX 787341-800-942-2050www.NationalDriverTraining.com

Texas Quick Reference Checklist:Print this page to use as a quick reference. Please read your welcome pack thoroughly for detailed instructions for the use of your driver education program.

Prepare for the Permit (steps 1-4 of your step-by-step guide on the next page) Register with the TDLR using form DL 92 or https://www.tdlr.texas.gov/ParentTaught/ParentTaughtNotice.aspx

Study for Permit Test: Complete “Your 1st 6 Hours” and Practice Permit Tests. (6 hour minimum with no more than 2 hours per day)

Request your DE 964E Texas Driver Education Certificate for 6 hours of study from NDT. This request happens automatically for online students and the certificate will appear on the student home page. Online students, download your permit packet. CD and book students must complete the DL 91A by hand. Obtain the Permit (step 5 of step-by-step guide) To Apply for the Permit, you need:

DE 964 E Texas Driver Education Certificate (most students download this from the student home page) DPS form DL-91A (modified) Classroom Instruction Log Record showing 6 hours of study (online users download this form after completing “Your 1st 6 Hours” online). Completed VOE (Verification of Enrollment and Attendance in School form) First Page of TDLR Parent Taught Driver Ed Program Guide (proof of registration with TDLR) The DL-90A Affidavit (completed and unsigned) The License Application form (unsigned) “Raised seal” birth certificate Social Security card for your teen Proof of Registration and Auto Insurance policy/statement for your vehicle (to prove residency) DPS fee for the permit

Complete the Progam **You must obtain the permit before completing the program.** Work through each of the 7 levels completing class and driving requirements and passing all 7 tests (step 6 of step-by-step guide)

Submit class and driving hours electronically (online course users) or on paper (CD-Rom and Book users) to request your DE-964E Driver education completion certificate and Driver License Packet which includes completed forms DL91A and B (step 7 of step-by-step guide).

As of September 1, 2015, after your 32 class hours but before obtaining a license, all students are required to take the 2-hour Impact Texas Teen Drivers (ITTD) program. Take it online for free at https://impacttexasteendrivers.dps.texas.gov/

Take a Driving Test to get Your License (step 9 of step-by-step guide) To apply for the license you need:

to hold the permit for 6 months be at least 16 years old DE 964E Texas Driver Education Certificate from NDT Completed DL 91 A with 32 class hours Completed DL 91 B with 50 driving hours 2 proofs of residency (see page 6 for more information) An up-to-date VOE Form Driver Education Affidavit, DL 90-B ITTD Certificate of Completion Your Valid Learners Permit

STEP-BY-STEP INSTRUCTION GUIDE - COURSE 102

Step 1: Verify that you have the proper course materials

NDT provides TDLR approved course 102 in an online format with a variety of available upgrades. Your customer enrollment form and receipt will identify the program materials you purchased. All enrollees have access to our online program. Access to the online program requires a login ID/customer ID and password (provided on your receipt). Your ID is a 6 digit number. Your password is your 8 digit date of birth formatted YYYYMMDD.Optional upgrades include the following:

• Program CD-Rom (ideal for customers without high speed internet access)• Driver Education Manual (the online curriculum printed and spiral bound)• Traffic Safety Video Library (full length videos viewable on your TV)

If any items are missing or if you wish to upgrade, please call 1-800-942-2050 for assistance.

Step 2: Register with the Texas Department of Licensing and Regulation (TDLR)

If you have not already sent the Request for a Parent Taught Driver Education Packet, Form DL-92 (use this link: https://www.tdlr.texas.gov/ParentTaught/ParentTaughtNotice.aspx or page 13 of this document), along with $20.00 to the TDLR in Austin, do so now (allow 3-6 weeks to process paper registrations). Including your e-mail address on the form may shorten processing times. List names of all parents / legal guardians who will be teaching your teen on this form. The TDLR will enter your teen in the DPS computer system to open a file on your teen in preparation for your teen’s permit test. You will recieve a PTDE pack from TDLR and you will need to take the first page (see image) when you apply for the permit.

Step 3: The TDLR Materials

You may begin tracking your teen’s study time once you have succesfully registered with the TDLR in Austin. The TDLR will send you the Application for Drivers License, and information about the various courses approved in Texas. You may remove the License Application Form and retain it. Please set aside all other materials in the TDLR packet and only use our curriculum material and forms. You do not need to apply for any other course materials because you are using Course 102.

Step 4: Complete your first 6 hours

Course 102 is a concurrent training program. Your teen must complete 6 hours of study before applying for a permit. Online students will complete their first 6 hours by logging in and clicking the button that says, “Your First 6 Hours.” CD Rom students will find this information on their CD-Rom. Book Students will have this information delivered in a printed format. Remember, the state of Texas does not accept more than 2 hours of study per day. You may also choose to access the Texas Driver Handbook through our link online or at http://www.txdps.state.tx.us/InternetForms/Forms/DL-7.pdf. You may find it helpful to quiz your student on his knowledge of the Texas Driver Handbook using the questions located in the back of that Handbook.

Upon completion of the 1st 6 Hours, you must request your DE 964E Texas Driver Education Certificate from NDT. Online students download it from the student home page at the end of the first 6 hours. CD and Book customers must submit (by email or mail) a copy of their DL-91A Classroom Instruction log showing completion of the 1st 6 hours. You may request the certificate to be sent by mail or e-mail.

Step 5: To the DPS for the Learners Permit

Collect the following documents to take to the DPS: • Receipt of Enrollment (in Permit Pack)• DE 964E Texas Driver Education Certificate for 6 hours of study (download or request by mail / email)• DPS form DL-91A (modified) Classroom Instruction Log Record with 6 hours of study. (in Permit Pack)• The DL-90A Affidavit (completed and unsigned) (in Permit Pack)• Completed VOE (Verification of Enrollment and Attendance in School form)

First Page of TDLR Parent Taught Driver Ed Program Guide (see step 2 above)• The License Application form (unsigned)• “Raised seal” birth certificate• Social Security card for your teen• Two proofs of residency. We reccomend Proof of Registration and Auto Insurance policy/statement for

your vehicle. A complete list of approved documents may be found on our website.• DPS fee for the permit

Your teenager will be administered the Texas Permit Test and, upon passing the test, be issued a permit. Call us on 800-942-2050 from the DPS office if any confusion should arise regarding our program. (If you have a cellular telephone, take it with you).

Step 6: Behind the Wheel

At this point, you may “Continue with the Online Course”. When you have obtained the permit and completed level 1, you are ready to begin behind-the-wheel instruction from level 1. Instruct your teen in the car according to the Level 1 BTW instructions. Upon passing Level 1, have your teen graduate to Level 2 and begin reading, testing, and then in-car instruction. Each level should be completed in this way. BTW guidelines are available to download and print from the online program. For your convenience, in-car guidelines are available from the “parents” section of the online program. As your teen works through the program, you will have the opportunity to your progress using the links in the program that say, “Update Class Hours” and “Update Driving Hours”. These forms help you organize and account for the dates on which you instruct and train.

Step 7: Course Completion

Upon completion of Level 7, you may apply for your course completion paperwork. In order to provide your DE 964E Texas Driver Education Certificate and your “Driver License Pack” which includes your class and driving logs, we need the following information:

• Passing test scores for all 7 levels. (Scores must be 90% or higher)• Parent Validation of 32 Class Hours• Parent Validation of 50 Driving Hours

Online students may download the DE 964E Texas Driver Education Certificate through the online course interface. The link will appear directly above the “Driver License Pack” when the course is complete. You willl need to print and take both documents to the DPS for the driver license test.

Students working from the CD or book will need to complete their DL91A and B forms by hand and mail or email in a copy (keep your original for the DPS) to us to request your DE 964E Texas Driver Education Certificate. You may mail in the copy of your logs to:

National Driver Training1901 Ranch Road 620 NLakeway, TX 78734

or scan and e-mail the logs to Info@NationalDriverTraining.com

Step 8: Impact Texas Teen Drivers CourseATTENTION: Effective, September 1, 2015, prior to obtaining a license, all students will be required to take the 2-hour Impact Texas Teen Drivers (ITTD) program. You may take the program free of charge. Register online at https://impacttexasteendrivers.dps.texas.gov/

If you visit a DPS location and have any issues concerning this please call the Driver Education section (512-424-5623) at DPS before leaving the station so they can help without having to make a return visit.

Step 9: Applying for the LicenseTake the following items with you to the DPS for the teen’s driver license:

• DE 964E Texas Driver Education Certificate for course completion• Completed DL 91A and B forms• An up-to-date VOE Form• Driver Education Affidavit, DL 90-B• ITTD Certificate of Completion• Your Valid Learners Permit• Proof of Insurance• Two proofs of residency. We recomend Proof of Registration and Auto Insurance policy/statement for

your vehicle. A complete list of approved documents may be found on the state’s website: https://www.txdps.state.tx.us/DriverLicense/residencyReqNonCDL.htm

• DPS fee for printing the driver’s license.

Important Texas Law UpdateHouse Bill 339 is now law in Texas and went into effect September 1st, 2009. More recently, House Bill 3483 went into effect October 1st, 2013. These laws presents significant changes for teen drivers. In summary, those changes are:

1. Texas law requires a minimum of 44 driving hours with at least 10 hours at night instead of 14 total driving hours. National Driver Training has required 50 hours of driving since our approval in 1997 and we will continue to hold to our high standard.

2. Parent eligibility requirements now include:a. Must have held a valid license for the past three yearsb. Must not have any felony driving convictionsc. Must have less than 6 points on their current driving recordd. Must not be disabled because of mental illness

3. Driving tests are now mandatory for all new drivers. Teen drivers may no longer waive the skills test with a state trooper.

4. Graduated Driver Licensing restrictions on the newly licensed driver are effective for the first year on the minor’s license. The restrictions include:

a. No driving between midnight and 5 am except for emergencies and school or work related activitiesb. No more than one passenger under age 21 who is not a family memberc. No use of wireless communications devices except in the case of an emergency.

National Driver Training Institute believes these law changes are sensible and necessary. They will save lives.

Using Course 102 in a Block FormatAlthough it is designed as a concurrent training program, Course 102 may be completed in the block format. In order to complete Course 102 as a block study course, you must instruct your teenager through all of the class instruction first, filling out the DL91A class log completely before you apply for the permit. Once the permit is obtained, you may review the class materials with your teen as you work through all of the driving standards.

How To Complete the DL 91AClassroom Instruction Log Record

NDTI’s Help for the Teenager Who Wants to Drive is a concurrent training program. This means the DL 91A form will be presented to the DPS on two occasions; for the permit after 6 hours of instruction, and for the license after the course is completed. NDTI Online students may complete and print the DL 91A from the online program using a simple online questionnaire. Students using the CD-Rom or book versions of the curriculum will receive a customized DL 91A with their material. This form is not valid unless you bring your enrollment receipt with it.

When applying for the permit the following fields must be completed: Student Name, Instructor Name, Classroom Instruction Began, Instructor License Number, Course Number, Student ID, and TDLR Approved Curriculum Utilized. Please do not complete the field for Classroom Instruction Completed.

You will also need to input the dates for the first 6 hours of classroom instruction. Classroom instruction may be given up to two (2) hours per day and includes reading from the Texas Driver Handbook as well as our Level 1 reading and videos. Here is a sample of how the DL 91A may be filled out in preparation for taking the permit test at your local DPS station:

Students in the online program will be able to download the DL 91A with the proper fields filled out for them by the computer. The dates are recorded as the student works through the permit preparation phase of the program entitled, “Your first 6 hours.”

CLASSROOM INSTRUCTION LOG RECORDNot Valid Without Accompanying Receipt With Identical Student ID

Student’s Name Instructor’s Name

Date Classroom Instruction Began Instructor’s Texas License Number

Date Classroom Instruction Completed Course Number Student ID:

Texas DPS Approved Curriculum Utilized

NOTICE: The classroom portion of the course may not be completed in less than 20 calendar days with a maximum of two hours of instruction in any one day.

Module Minimum HoursRequired Hours

Date of Instruction

Module 1 / Level 1: Texas Driver Responsibilites - Knowing Texas Traffic Laws. (Requires a thorough study of the Texas Driver Handbook and Help for the Teenager Who Wants to Drive Level 1 part 1).

6 Hours(360 Minutes)

Hour 1

Hour 2

Hour 3

Hour 4

Hour 5

Hour 6

Module 2 / Levels 1 & 2: Texas Driver Responsibilites - Preparing to Operate a Vehicle. (Level 1 - Familiarity with the vehicle, Reference Points, Level 2 - Visibility)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 3 / Level 2: Basic Maneuvering Tasks - Low Risk Driving Environment (Level 2 - Sharing the Road, Right-of-Way)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 4 / Level 3 & 4: Basic Maneuvering Tasks - Moderate Risk Driving Environment (Level 3 - Traffic, Traffic Controls, Aggressive Drivers, Level 4 - Space Maintenance)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 5 / Level 4: Information Processing - Moderate Risk Driving Environment (Level 4 - Navigation, Following Distance)

2 Hours(120 Minutes)

Hour 1

Hour 2

Module 6 / Levels 2 & 5: Information Processing - Complex Risk Driving Environment(Level 2 - Awareness, Level 5 - Adjust Speed)

2 Hours(120 Minutes)

Hour 1

Hour 2

Module 7 / Levels 2, 3, & 7: Driver Performance - Personal Factors (Level 2 - Distractions, Level 3 - Drivers impaired physically, by illness, or drowsy, Level 7 - Alcohol, illegal drugs, prescription drugs, OTC medicines)

6 Hours(360 Minutes)

Hour 1

Hour 2

Hour 3

Hour 4

Hour 5

Hour 6

Module 8 / Levels 5 & 6: Driver Responsibilites - Adverse Conditions (Level 5 - Adverse Weather, Level 6 - Traction Loss)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 9 / Level 6: Driver Responsibilites - Vehicle Functions (Level 6 - Vehicle Technologies)

2 Hours(120 Minutes)

Hour 1

Hour 2

Module 10 / Level 7: Driver Responsibilites - Making Informed Choices (Level 7 - Vehicle Purchase, Insurance, Security)

2 Hours(120 Minutes)

Hour 1

Hour 2

Total 32 hours(1920 Minutes)

The Classroom Instruction should be taught in accordance with your course guidelines and recorded above.

*You will be required to present this form and a copy of your customer receipt at the Driver License Office when the student applies for an Instruction Permit.

DL-91A Modified-Course 102

Course 102

National Driver Training’s “Help for the Teenager Who Wants to Drive”

Course 102 follows the CONCURRENT program. The student should apply for and obtain an instruction permit from the Texas Department of Public Safety upon successful completion and mastery of Module 1 / Level 1. This must include a minimum of 6 hours of classroom instruction.

Under NO circumstances may ANY behind-the-wheel instruction and/or in-car supervised practice be permitted UNTIL an instruction permit has been issued to the student by the Texas Department of Public Safety.

SAMPL

ESheryl Harper Martyn Harper

January 2, 2010 87654321

50123

01/02/1001/02/1001/03/1001/03/1001/04/1001/04/10

How To Complete the DL 91AClassroom Instruction Log Record (cont)

Once the teen has an instruction permit, he or she must still complete the remaining 26 hours of classroom instruction as well as Behind-The-Wheel instruction through our program. Total combined class and driving instruction are not to exceed 2 hours in one day. Here again, online students may complete this form using the links in the online program.

Note: the DL 91A Classroom Instruction Log Record is built on a Texas standard 10 module outline. NDTI’s program is divided into seven levels to more easily associate the required driving instruction with the class time. Your classroom instruction hours will not appear on the DL 91 A in date order (see sample form below).

Remember, a teen must hold a permit for at least 6 months. Your family may find it beneficial to take a slow pace through the program. Be sure to copy the final date of instruction into the “Classroom Instruction Completed” field in the header of the form.The following sample form illustrates how to complete the DL 91A on a very aggressive training schedule with one hour devoted each day until the classroom instruction is completed:

CLASSROOM INSTRUCTION LOG RECORDNot Valid Without Accompanying Receipt With Identical Student ID

Student’s Name Instructor’s Name

Date Classroom Instruction Began Instructor’s Texas License Number

Date Classroom Instruction Completed Course Number Student ID:

Texas DPS Approved Curriculum Utilized

NOTICE: The classroom portion of the course may not be completed in less than 20 calendar days with a maximum of two hours of instruction in any one day.

Module Minimum HoursRequired Hours

Date of Instruction

Module 1 / Level 1: Texas Driver Responsibilites - Knowing Texas Traffic Laws. (Requires a thorough study of the Texas Driver Handbook and Help for the Teenager Who Wants to Drive Level 1 part 1).

6 Hours(360 Minutes)

Hour 1

Hour 2

Hour 3

Hour 4

Hour 5

Hour 6

Module 2 / Levels 1 & 2: Texas Driver Responsibilites - Preparing to Operate a Vehicle. (Level 1 - Familiarity with the vehicle, Reference Points, Level 2 - Visibility)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 3 / Level 2: Basic Maneuvering Tasks - Low Risk Driving Environment (Level 2 - Sharing the Road, Right-of-Way)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 4 / Level 3 & 4: Basic Maneuvering Tasks - Moderate Risk Driving Environment (Level 3 - Traffic, Traffic Controls, Aggressive Drivers, Level 4 - Space Maintenance)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 5 / Level 4: Information Processing - Moderate Risk Driving Environment (Level 4 - Navigation, Following Distance)

2 Hours(120 Minutes)

Hour 1

Hour 2

Module 6 / Levels 2 & 5: Information Processing - Complex Risk Driving Environment(Level 2 - Awareness, Level 5 - Adjust Speed)

2 Hours(120 Minutes)

Hour 1

Hour 2

Module 7 / Levels 2, 3, & 7: Driver Performance - Personal Factors (Level 2 - Distractions, Level 3 - Drivers impaired physically, by illness, or drowsy, Level 7 - Alcohol, illegal drugs, prescription drugs, OTC medicines)

6 Hours(360 Minutes)

Hour 1

Hour 2

Hour 3

Hour 4

Hour 5

Hour 6

Module 8 / Levels 5 & 6: Driver Responsibilites - Adverse Conditions (Level 5 - Adverse Weather, Level 6 - Traction Loss)

3 Hours(180 minutes)

Hour 1

Hour 2

Hour 3

Module 9 / Level 6: Driver Responsibilites - Vehicle Functions (Level 6 - Vehicle Technologies)

2 Hours(120 Minutes)

Hour 1

Hour 2

Module 10 / Level 7: Driver Responsibilites - Making Informed Choices (Level 7 - Vehicle Purchase, Insurance, Security)

2 Hours(120 Minutes)

Hour 1

Hour 2

Total 32 hours(1920 Minutes)

The Classroom Instruction should be taught in accordance with your course guidelines and recorded above.

*You will be required to present this form and a copy of your customer receipt at the Driver License Office when the student applies for an Instruction Permit.

DL-91A Modified-Course 102

Course 102

National Driver Training’s “Help for the Teenager Who Wants to Drive”

Course 102 follows the CONCURRENT program. The student should apply for and obtain an instruction permit from the Texas Department of Public Safety upon successful completion and mastery of Module 1 / Level 1. This must include a minimum of 6 hours of classroom instruction.

Under NO circumstances may ANY behind-the-wheel instruction and/or in-car supervised practice be permitted UNTIL an instruction permit has been issued to the student by the Texas Department of Public Safety.

SAMPL

ESheryl Harper Martyn Harper

January 2, 2010 87654321

50123

01/02/1001/02/1001/03/1001/03/1001/04/1001/04/1001/06/1001/07/1001/08/1001/09/10

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01/10/10

January 29, 2010

01/30/10

How To Complete the DL 91BBehind-The-Wheel Instruction Log Record

Once the teen has an instruction permit, he or she may begin Behind-The-Wheel instruction through our program. Behind-The-Wheel instruction and Supervised Practice must not exceed 1 hour per day. Total combined class and driving instruction are not to exceed 2 hours in one day. As Behind-The-Wheel instruction hours are completed, log them in the appropriate box. Online students may complete this form using the tools in the online program.

Note: the DL 91B Behind-The-Wheel Instruction Log Record is built on a Texas standard 10 module outline. NDTI’s program is divided into seven levels to more easily associate the required driving instruction with the class time. Your Behind-The-Wheel instruction and Supervised Driving hours will not appear on the DL 91 B in date order (see sample form below).

Remember, a teen must hold a permit for at least 6 months. National Driver Training believes you will gain the greatest benefit by taking a slow pace through the program.

The following sample form illustrates how to complete the DL 91B on a very aggressive training schedule with one hour devoted each day until the Behind-The-Wheel instruction and Supervised Driving are completed:

BEHIND-THE-WHEEL INSTRUCTION LOG RECORDNot Valid Without Matching DL 91A

Student’s Name Student’s Texas Instruction Permit Number

Instructor’s Name Instructor’s Texas License Number

Course Number Date Behind-the-Wheel Instruction Began

Student ID Date Behind-the-Wheel Instruction Completed

The student cannot begin the Behind-the-Wheel instruction and/or in-car supevised practice UNTIL a Texas Instruction Permit has been issued to the studen by the Texas Department of Public Safety.

The combined hours of classroom instruction and/or in-car instruction/practice may NOT exceed a total of TWO hours of instruction in one(1) day. The combined hours of Behind-the-Wheel instruction and in-car supervised practice may NOT exceed ONE hour of instrucion in one (1) day. The Behind-the-Wheel instruction may NOT be completed in less than 14 calendar days.

Classroom and Concurrent Programs: Module One, Instructional Topic, 1.1.1-1.1.6Under the Concurrent program, after successfully completing and mastering the required hours from Module One, the student driver may apply for and obtain an instruction permit from the Texas Department of Public Safety. Under the Block program, the entire classroom portion of driver edu-caiton must be completed prior to application for the instruction permit. A student without a valid instruction permit in his/her possession shall not receive Behind-the-Wheel training no matter when the instruction is provided as specified by the Texas Administrative Code.(The licensing process cannot be credited as classroom, Behind-the-Wheel, or in-car observation training although it is identified as an instructional objective.)

Behind-The-Wheel Instruction and In-Car Supervised Practice Instruction Modules/Levels

Behind-The-Wheel Instruction Completed

(Minimum Required)

In-Car SupervisedPractice Completed

(Minimum Required)

Beginning Dates of Behind-The-Wheel and In-Car Practice.

Ending Dates of Behind-The-Wheel and In-Car Practice

Module 2.2 / Level 1Pre-Drive, Occpant Protection, Symbols, Devices

Starting, Vehicle Operation, Post-Drive

30 minutes

30 minutes

Module 3.2 / Level 2Visual Attention, Communication, Reference Points

Vehicle Balance,Vehicle Manuevers

60 minutes

60 minutes

Module 4.2 / Level 3Driving Practices, Fatigue, Aggresive Driving

Basic Maneuvers, Sharing Road w/Impaired Driver

60 minutes

60 minutes

Module 5.2 / Level 4Risk Factors, Space Management,

45 minutes

45 minutes

Module 6.2 / Levels 3 & 5Share the Road w/Pedestrian and Vehicle Traffic

Identify Conditions of Greater Risk

60 minutes

60 minutes

Module 7.2 / Level 5Recognize/React to Distracted Drivers,

Drive in Areas of Moderate to Complex Risk

45 minutes

45 minutes

Module 8.2 / Level 5Vehicle Movement and Reference Points

Advanced Parking Maneuvers

45 minutes

45 minutes

Module 9.2 / Level 7Comprehensive In-Car Progress Assessment

45 minutes

45 minutes

Module 10.2 / Level 6Emergency Braking and Steering

Vehicle Safety Technologies

30 minutes

30 minutes

Total 7 hours 7 hours

The Behind-The-Wheel and In-Car Practice Instruction should be taught in accordance with your course guidelines and recorded above.

*You will be required to present this form at the Driver License Office when the student applies for a Texas Driver License

DL-91B Modified-Course 102

Course 102

SAMPL

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How To Complete the DL 91B (cont)Behind-The-Wheel Instruction Log Record

In addition to the initial 14 hours of Behind-The-Wheel Instruction and Supervised Practice, the State of Texas requires and additional 30 hours of Supervised Practice. Historically, National Driver Training has required an additional 36 hours of Supervised Practice. Log these additional Supervised Practice Hours on the DL 91B(cont) form. You must not log more than one hour of additional Supervised Practice per day. Here again, this form may be completed online using the interface in the program. Your additional Supervised Driving hours should appear on the DL 91B(cont) in date order (see sample form below).

Below the supervised driving hours, you will find a table in which you may enter night driving hours. As of May 1st, Texas requires you to complete 10 hours of night driving.

Remember, a teen must hold a permit for at least 6 months. National Driver Training believes you will gain the greatest benefit by taking a slow pace through the program.

The following sample form illustrates how to complete the DL 91B(cont) on a very aggressive training schedule with one hour devoted each day until the additional Supervised Driving hours are completed:

BEHIND-THE-WHEEL INSTRUCTION LOG RECORD (CONT)Not Valid Without Matching DL 91A

Student’s Name Student’s Texas Instruction Permit Number

Instructor’s Name Instructor’s Texas License Number

Course Number Date Behind-the-Wheel Instruction Began

Student ID Date Behind-the-Wheel Instruction Completed

The student cannot begin the Behind-the-Wheel instruction and/or in-car supevised practice UNTIL a Texas Instruction Permit has been issued to the studen by the Texas Department of Public Safety.

The combined hours of classroom instruction and/or in-car instruction/practice may NOT exceed a total of TWO hours of instruction in one(1) day. The combined hours of Behind-the-Wheel instruction and in-car supervised practice may NOT exceed ONE hour of instrucion in one (1) day. The Behind-the-Wheel instruction may NOT be completed in less than 14 calendar days.

In addition to the 7 hours of Behind-The-Wheel instruction and 7 hours of in-car supervised driving, Texas law requires additional supervised driving and Course 102 requires that the additional time equal 36 hours of driving not including the hours recorded on the front side of this form. Use this form to log additional in-car practice hours. Dates recorded on this side of the form must not include dates recorded on the front side of the form.(The licensing process cannot be credited as classroom, Behind-the-Wheel, or in-car observation training although it is identified as an instructional objective.)

AdditionalIn-Car SupervisedPractice Completed

Beginning Dates of additional

In-Car Practice.

Ending Dates of additional

In-Car Practice

60 minutes 02/01/10 02/01/10

60 minutes 02/02/10 02/02/10

60 minutes 02/03/10 02/03/10

60 minutes 02/04/10 02/04/10

60 minutes 02/05/10 02/05/10

60 minutes 02/06/10 02/06/10

60 minutes 02/07/10 02/07/10

60 minutes 02/08/10 02/08/10

60 minutes 02/09/10 02/09/10

60 minutes 02/10/10 02/10/10

60 minutes 02/11/10 02/11/10

60 minutes 02/12/10 02/12/10

60 minutes 02/13/10 02/13/10

60 minutes 02/14/10 02/14/10

60 minutes 02/15/10 02/15/10

60 minutes 02/16/10 02/16/10

60 minutes 02/17/10 02/17/10

60 minutes 02/18/10 02/18/10

The Behind-The-Wheel and In-Car Practice Instruction should be taught in accordance with your course guidelines and recorded above.

*You will be required to present this form at the Driver License Office when the student applies for a Texas Driver License

DL-91B Modified-Course 102

AdditionalIn-Car SupervisedPractice Completed

Beginning Dates of additional

In-Car Practice.

Ending Dates of additional

In-Car Practice

60 minutes 02/19/10 02/19/10

60 minutes 02/20/10 02/20/10

60 minutes 02/21/10 02/21/10

60 minutes 02/22/10 02/22/10

60 minutes 02/23/10 02/23/10

60 minutes 02/24/10 02/24/10

60 minutes 02/25/10 02/25/10

60 minutes 02/26/10 02/26/10

60 minutes 02/27/10 02/27/10

60 minutes 02/28/10 02/28/10

60 minutes 03/01/10 03/01/10

60 minutes 03/02/10 03/02/10

60 minutes 03/03/10 03/03/10

60 minutes 03/04/10 03/04/10

60 minutes 03/05/10 03/05/10

60 minutes 03/06/10 03/06/10

60 minutes 03/07/10 03/07/10

60 minutes 03/08/10 03/08/10

Total: 36 hours of additional in-car practice

Course 102

Cheryl Harper

50125

Texas law now requires minors to complete at least 10 hours of night driving. In the spaces below, identify the dates over which your teen completed the 10 required night driving hours. These dates will most likely come from supervised driving hour dates recorded in the tables above.

10 Night Driving Hours were completed over the following dates:

Hour 1 02/04/10 Hour 2 02/07/10 Hour 3 02/15/10 Hour 4 02/20/10 Hour 5 02/21/10

Hour 6 02/24/10 Hour 7 02/26/10 Hour 8 03/01/10 Hour 9 03/04/10 Hour 10 03/07/10

Marilyn Harper

10987654

87654321

January 6th, 2010

March 8th 2010

SAMPL

E

Additional Texas Forms

Forms DL 91A and B are secure forms that must be obtained through your customer file either online at www.NationalDriverTraining.com or by calling our office at 1-800-942-2050.

For your convenience, the following forms are available in this packet and online at www.NationalDriverTraining.com/texas_drivereducation.php

• DL 92 Request for Parent Taught Driver Education Packet• DL 14A Driver License Application• DL 90A Parent Taught Driver Education Affidavit (for permit)• Texas Education Agency Verification of Enrollment and Attendance Form (for permit)• DL 90B Parent Taught Driver Education Affidavit (for license)• DL 40 Supplemental Examination• Texas Education Agency Verification of Enrollment and Attendance Form (for license)

REQUEST FOR A PARENT TAUGHT DRIVER EDUCATION (PTDE) PACKET

PROGRAM ELIGIBILITY REQUIREMENTS A. The student must be 14 years of age prior to beginning the classroom portion; however they may not test for a learner license until their 15th birthday.B. No instruction is permitted prior to receipt of the Parent Taught Driver Education Packet. Any instruction prior to that time will not be accepted

toward the required instruction time. C. A minimum of 76 hours of actual instruction time is required to instruct this course and it is estimated that an equal number of hours for prepara-

tion are required for an instructor to properly teach this course. The classroom thirty-two hours must not be completed in fewer than sixteen calendar days. The behind the wheel forty-four hours must not be completed in fewer than forty-four calendar days. A student shall not be instructed more than two hours in one (1) day.

D. This course may or may not qualify for a discount for automobile insurance purposes due to Department of Insurance rules. You should consult with your insurance carrier concerning this matter.

E. No behind the wheel instruction or practice may be permitted until the student has been issued a learner license. Driving without a valid license on a public street or highway is violation of state law. Any behind the wheel instruction prior to issuance of the learner license will not be accepted toward the required instruction or practice time.

F. Instructor must be the student’s parent, step-parent, grandparent, foster parent or legal guardian appointed by a court of competent jurisdiction. A power of attorney is not legally sufficient.

G. The instructor must have a valid driver license for the preceding three years; or if active military personnel or spouse, a valid driver license from state of permanent residency or last duty station for the preceding three years.

H The instructor cannot have a conviction (including a probated sentence) of criminally negligent homicide or driving while intoxicated. The instructor must not have had their driving privileges suspended, revoked or forfeited for traffic related violations in the past three years. The instructor

cannot have six or more points assigned to their driver license. The instructor is responsible for checking both their criminal or driver records prior to requesting the packet. The Department will verify the instructor’s record at the time of processing the student’s learner license and again at the time of processing the student’s provisional driver license. If at that time, we determine that the instructor does not meet the requirements, we will deny the learner license or provisional driver license along with any prior classroom instruction or behind the wheel/in the car instruction provided by the ineligible instructor.

I. The instructor may go to any local driver license office to have the student apply for the license and take the required test. (Some stations require an appointment or may allow online scheduling for the skills test.)

J. DO NOT MAIL CASH, Mail check or money order payable to: Texas Department of Licensing and Regulation. A separate request form and non-refundable fee are required for each student who will participate in the PTDE program.

NOTE: ALL INFORMATION AND REQUIRED FEES MUST BE SUBMITTED BEFORE A PARENT TAUGHT DRIVER EDUCATION PACKET WILL BE MAILED OR EMAILED. PLEASE ALLOW 2-3 WEEKS FOR DELIVERY IF PACKET IS TO BE MAILED.

PO Box 12157 Austin, Texas 78711-2157 (800) 803-9202 (512) 463-6599 FAX (512) 475-2871

www.tdlr.texas.gov cs.driver.education.safety@tdlr.texas.gov

1. INSTRUCTOR’S NAME - Print/Type your legal name in the spaces provided. (First, Middle Name, Last, Suffix) Examples of a suffix include Jr., Sr., and III. (Mr. is not a suffix.)

2. INSTRUCTOR’S MAILING ADDRESS - Print/Type your current mailing address. This is the address where we will send you mail. This address can be a post office box. You can add the zip plus-4 to help the postal service deliver mail more efficiently and accurately.

3. INSTRUCTOR’S PHONE NUMBER - Print/Type a telephone number, including the area code, where we can reach you during the day. This may be your office phone number where we can leave a message.

4. INSTRUCTOR’S EMAIL ADDRESS - Print/Type your email address. Please provide your email address so the department may email license information and required notices to you. Your email address is confidential pursuant to the Texas Public Information Act, and the department will not share it with the public. Check the box if you would like to have the packet emailed.

5. STUDENT’S NAME - Print/Type your legal name in the spaces provided. (First, Middle Name, Last, Suffix) Examples of a suffix include Jr., Sr., and III. (Mr. is not a suffix.)

6. STUDENT’S DATE OF BIRTH - Write your birthdate.

7. INSTRUCTOR’S SIGNATURE

REQUEST FOR A PARENT TAUGHT DRIVER EDUCATION (PTDE) PACKET

PO Box 12157 Austin, Texas 78711-2157 (800) 803-9202 (512) 463-6599 FAX (512) 475-2871www.tdlr.texas.gov cs.driver.education.safety@tdlr.texas.gov

MAIL THE REQUEST FORM AND $20.00 FEE TO TDLR (FEE IS NON-REFUNDABLE)

PAYMENTS MUST BE IN THE FORM OF A CHECK OR MONEY ORDER PAYABLE TO TDLR

TDLR Form DL-92.1 rev September 2015

1. Instructor’s Name: ________________________ _______________________ ___________________________________ _________

First Name Middle Name Last Name Suffix (JR, SR, III)

6. Student’s Date of Birth:

__________ - _________ - _________ Month Day Year

3. Instructor’s Phone Number:

(_______________) ____________________________________________________ Area Code Phone Number

2. Instructor’s Mailing Address:

Number, Street Name, Apartment Number

_________________________________________________________________________________________ City State Zip Code

4. Instructor’s Email Address:

________________________________________________________ (Ex: johndoe@aol.com) See instruction sheet for disclosure information

ALL INFORMATION MUST BE TYPED OR PRINTED IN BLACK INK Instructor’s Information (Parent or Legal Guardian). Parent Taught Driver Education Packet will be mailed to the address below.

5. Student’s Name: ________________________ _______________________ ___________________________________ _________

First Name Middle Name Last Name Suffix (JR, SR, III)

Student’s Information

Check to have packet emailed

7. Instructor’s Signature:

___________________________________________________________________ ______________________ Instructor Signature Date

ALL INFORMATION AND REQUIRED FEE MUST BE SUBMITTED BEFORE A PARENT TAUGHT DRIVER EDUCATION PACKET WILL BE MAILED OR EMAILED. PLEASE ALLOW 2-3 WEEKS FOR DELIVERY IF

PACKET IS TO BE MAILED.

Appendix M

IDENTIFICATION CARD NON-RESIDENT COMMERCIAL DRIVER LICENSE Class (Circle) A B C M

APPLICANT INFORMATION

LAST NAME:

FIRST NAME:

MIDDLE NAME:

SUFFIX:

MAIDEN NAME:

CONTACT INFORMATION

HOME PHONE:

OTHER PHONE:

EMAIL:

ADDRESS INFORMATION

RESIDENCE ADDRESS: DATE OF BIRTH (mm/dd/yyyy): — —

SSN: — —

SEX: (Circle One) MALE FEMALE

EYE COLOR: HAIR COLOR:

CITY: STATE:

ZIP CODE: COUNTY:

MAILING ADDRESS: RACE/ ETHNICITY: (I) American Indian/Alaska Native

(A) Asian/ Pacific Islander (B) Black (H) Hispanic (O) Other (W) White

HEIGHT: ft. in. WEIGHT: lbs. CITY: STATE:

ZIP CODE: COUNTY: PLACE OF BIRTH: CITY: COUNTY: STATE: COUNTRY:

FATHER’S LAST NAME: MOTHER’S MAIDEN NAME:

YES NO 1. Are you a citizen of the United States? 2. If you are a US citizen, would you like to register to vote? If registered, would you like to update your voter information?

By providing my electronic signature, I understand the personal information on my application form and my electronic signature will be used for submitting my voter’s registration application to the Texas Secretary of State’s office. Wanting to register to vote, I authorize the Department of Public Safety to transfer this information to the Texas Secretary of State.

3. Do you wish to donate $1.00 to the Blindness Education Screening and Treatment Program? 4. Do you wish to donate $1.00 to the Glenda Dawson Donate Life – Texas Registry? 5. Would you like to register as an organ donor? 6. Do you want to support Texas Veterans? If yes, please indicate your donation amount $ .00 7. Do you have a health condition that may impede communication with a peace officer? If yes, please list

(physician must complete form DL-101 prior to the issuance of a DL/ID). 8. a) Do you want a Veteran designator on your driver license or identification card? (proof of Honorable discharge required; acceptable documents

are DD214/5, NGB22, VA disability letter, proof of service/verification of honorable service card) b) Are you a 60% disabled Veteran receiving compensation and want to waive the application fee? (see 8a for documents required)

9. In the event of injury or death would you like to provide two (2) emergency contacts? If yes, please list: a) Name Telephone Number Address b) Name Telephone Number Address

10. Have you ever had a Texas identification card? Number When? 11. Have you ever had a driver license or instruction permit in Texas? Number When? 12. Have you ever had a license or instruction permit in any other state? List state(s)

Number(s) When?

YES NO DRIVING HISTORY INFORMATION

13. Are you enrolled in or have you completed an approved driver education course? 14. Is your driver license or driver privilege CURRENTLY or EVER been suspended, revoked, canceled, denied or disqualified in ANY state?

Where? When? Why?

VEHICLE REGISTRATION AND INSURANCE INFORMATION 15. Do you own a motor vehicle which is required to be registered (Texas Transportation Code Section 502.040)? 16. Do you own a motor vehicle which is required to have liability insurance OR other proof of financial responsibility in compliance with the

Motor Vehicle Safety Responsibility Act (Texas Transportation Code Section 601.051)?

UNITED STATES SELECTIVE SERVICE Any male United States citizen or immigrant who is at least 18 years of age but less than 26 years of age submitting this application consents to registration with the United States Selective Service System. You must be registered to qualify for federal student aid ( to include Pell grant), job training, federal employment, and citizenship if an immigrant. In Texas, you must be registered to qualify for state college student aid or state employment. If convicted, failure to register with the Selective Service is a felony punishable by up to five years in prison and/or a $250,000 fine. If not registered by age 26, you can no longer register and could permanently lose those benefits associated with registration. For alternative options for applicants who object to conventional military service for religious or other conscientious reasons information is available at: http://www.sss.gov/FactSheets/FSaltsvc.pdf.

DL-14A (Rev. 6/14) APPLICATION CONTINUED ON BACK

REQUIRED INFORMATION FROM DRIVER LICENSE APPLICANTS

REQUIRED INFORMATION FROM ALL APPLICANTS

FOR DEPARTMENT USE ONLY RESTRICTIONS/ENDORSEMENTS

ASSIGNED #

APPLICATION FOR TEXAS DRIVER LICENSE OR IDENTIFICATION CARD NOTICE: All information on this application must be in INK. Applications held only 90 days.

DPS CANNOT REFUND PAYMENT ONCE APPLICATION IS SUBMITTED.

APPLICATION for: DRIVER LICENSE COMMERCIAL DRIVER LICENSE (CDL) LEARNER LICENSE

YES NO MEDICAL HISTORY QUESTIONS

1. Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely operate a motor vehicle?

EXAMPLES, including but not limited to: Diagnosis or treatment for heart trouble, stroke, hemorrhage or clots, high blood pressure, emphysema (within past two years) • progressive eye disorder or injury (i.e., glaucoma, macular degeneration, etc.) • loss of normal use of hand, arm, foot or leg • blackouts, seizures, loss of consciousness or body control (within the past two years) • difficulty turning head from side to side • loss of muscular control • stiff joints or neck • inadequate hand/eye coordination • medical condition that affects your judgment • dizziness or balance problems • missing limbs Please explain and identify medical condition: 2. Within the past two years, have you been diagnosed with, been hospitalized for or are you now receiving treatment for a psychiatric disorder? 3. Have you ever had an epileptic seizure, convulsion, loss of consciousness, or other seizure? 4. Do you have diabetes requiring treatment by insulin? 5. Do you have any alcohol or drug dependencies that may affect your ability to safely operate a motor vehicle or have you had any episodes

of alcohol or drug abuse within the past two years? 6. Within the past two years have you been treated for any other serious medical conditions? Please explain:

7. Have you EVER been referred to the Texas Medical Advisory Board for Driver Licensing?

DO NOT SIGN BELOW UNTIL INSTRUCTED TO DO SO BY NOTARY PUBLIC OR DRIVER LICENSE EMPLOYEE.

SOCIAL SECURITY NUMBER COLLECTION DISCLOSURE Disclosure of your social security account number is mandatory for driver license applicants, but voluntary for identification card applicants. This information is solicited pursuant to 42 U.S.C. 405(c)(2)(C)(i), 42 U.S.C. 666(a)(13)(A); 49 C.F.R. 383.153, Texas Family Code Section 231.302(c)(1) and Texas Transportation Code Sections 522.021 and 521.142. The Department will use social security number information for identification purposes and will only release the number to the Child Support Enforcement Division of the Attorney General’s Office, the U.S. Selective Service Administration, the Texas Secretary of State and the Health and Human Services Commission for statutorily authorized purposes pursuant to Texas Transportation Code Section 521.044.

VERIFICATION

Sworn to and subscribed before me this day of ,

Notary Public in and for the State of Texas/Authorized Officer

PARENTAL AUTHORIZATION Required for all driver license applicants under the age of 18

I do solemnly swear, affirm, or certify that I am the person named herein, that the statements on this application are true and correct,that the above named applicant is my ( ) child ( ) stepchild ( ) ward, and that I have legal custody of the applicant. I authorize the Departmentof Public Safety to issue a Class ( ) A, ( ) B, ( ) C, or ( ) M license to said minor. The Department can access the said minor’s schoolenrollment records from the Texas Education Agency, and a school administrator or law enforcement officer is authorized to notify theDepartment if the said minor is absent from school for at least 20 consecutive instructional days.

Usual Written Signature of Parent or Guardian Driver License Number

WAIVER OF PARENTAL AUTHORIZATION

Date

Parental Authorization waived. Signature of Applicant DL Employee ACID

Texas law requires the Texas Department of Public Safety must provide every minor applicant (under age 18), and cosigner, for a driver license in Texas, educational information concerning state laws relating to driving while intoxicated, driving by a minor with alcohol in the minor’s sys-tem, and the implied consent law. The minor applicant and the cosigner must acknowledge receipt of that information prior to issuance of anydriver license or permit. I hereby acknowledge receipt of the information concerning DWI, the Zero Tolerance Law and the Implied Consent Law.

Minor Applicant Parent/Legal Guardian Date of Receipt

CERTIFICATION I do solemnly swear, affirm, or certify that I am the person named herein and that the statements on this application are true and correct. Ifurther certify my residence address is a (check one): ( ) single family dwelling, ( ) apartment, ( ) motel, ( ) temporary shelter. Iagree to immediately report to the Texas Department of Public Safety any changes in my medical condition which may affect my ability to safelyoperate a motor vehicle. I further understand that I am required by law to report any change of name or address to the Department of Public Safety within thirty days. X

Signature of Applicant Date

NOTICE: The information on this application is required by the Texas Driver License Act, Texas Transportation Code Chapter 521. Failure to provide the information is cause for refusal to issue a driver license or identification card, and in some cases, cancellation or withdrawal of driving privileges. False information could also lead to criminal charges with penalties of a fine up to $4,000.00 and/or jail.

DRIVER LICENSE APPLICANTS Answers to 1 through 7 below are for the confidential use of the Department.

Driver License Division

Appendix D   

Classroom Instruction – Driver Education Affidavit For Class C Learner License

 All information on this affidavit, except the signature, must be typed or printed in black ink. The signature must be written in black ink.

  

I, , valid driver license number , hereby certify that(Instructor’s Legal Name) (Driver License Number)

 the following information contained in this form is true and correct. I am the instructor of , whose

(Student’s Legal Name) 

date of birth is , thereby meeting the age requirement to obtain a Class C learner license.(MM-DD-YYYY)

 I certify that for the above-named student, I am the:

 Parent Legal guardian Step-parent Step-grandparent Foster parent

Grandparent I acknowledge if one of the above relationships doesn’t apply, then by law, I’m not authorized to teach

Parent Taught Drivers Education.

I certify that I: 

1. Have submitted the $20 fee to enroll in the Texas Department of Licensing and Regulation’s Parent Taught Driver Education Program prior to beginning any instruction.

 2. Possessed a valid driver license for the preceding three years;

 3. Have not been convicted of Criminally Negligent Homicide;

 4. Have not been convicted of Driving While Intoxicated;

 5. Have not had my driving privileges suspended, revoked or forfeited in the past three years;

 6. Had less than six surcharge points assigned to me at the time I began instructing the above-named student; and

 I certify that I have instructed my student in the following Texas Department of Licensing and Regulation approved course of instruction:

 32 hours of classroom instruction under the Block Driver Education Program

Completion Date 

6 hours of classroom instruction under the Concurrent Driver Education Program Completion Date

 Title of TDLR-Approved PTDE Training Course: Course Number:

 I acknowledge that falsely certifying the information contained in this affidavit will subject me to criminal penalties under Texas Transportation Code 521.454.

  

(Signature) (Date) 

Sworn to and subscribed before me this day of , 20 .  

(Notary Public in and for the State of Texas/Authorized Officer) 

NOTE: One affidavit is required for each instructor who taught a student in each phase of the course. If there is more than one instructor, this form may be photocopied for use by the other instructor(s). All instructors must accompany the student when applying for a learner license. This affidavit must be signed either before a Driver License employee at the driver license office or before a Notary Public before coming to the driver license office. The document(s) must be presented when the student applies for a learner license. Definition of a qualified instructor can be found in the PTDE Information Packet.

  

DL-90A (Rev. 8/15)

Help for the Teenager Who Wants to Drive 102

Form CDD-104 Revised 1/2006

School Name County-District-Campus No. (If Applicable)

Verification of Enrollment and Attendance (VOE) Form Planned Use of Data: To provide documentation of enrollment and attendance status to the Texas Department of Public Safety (DPS) for a student applying for an instruction permit and/or a license to operate a motor vehicle. The student presents the completed form to DPS. DONOT return this form to the Texas Education Agency. Authority: The Texas Transportation Code (TRC) requires students who have not obtained a high school diploma or its equivalent to be enrolled in a public, charter, home, or private school; GED Program; or Institution of Higher Education and meet specific enrollmentconditions to obtain or renew a license. This requirement applies to persons under 18 years of age. Contacts: Contact local DPS driver license office or DPS Headquarters website: www.txdps.state.tx.us and e-mail: pio@txdps.state.tx.us(512-424-2000) or Texas Education Agency website: www.tea.state.tx.us and e-mail: nina.saint@tea.state.tx.us (512-463-9574). Issuing VOE Forms: SEE flow chart for issuance at http://www.tea.state.tx.us/safedriver/voe04.html. The issuance or denial of the VOE form is strictly a local school, charter, GED program, or institution decision. Neither TEA nor DPS can alter a VOE decision. Schools,Charters, GED programs, and institutions of higher education can impose and enforce conditions and restrictions on enrollment andattendance as it pertains to VOE eligibility that exceed minimum restrictions defined by law and rule. It is recommended that schools, charters, GED programs, and institutions of higher education clearly outline all requirements for issuance of the VOE form and establish a formal, published policy to support the requirements. The VOE form does not have to be signed by the student in the presence of the person certifying attendance. The signature of the student can be placed on the form before or as it is presented to DPS. NOTE: Texas Education Code 25.092 (excerpted), Minimum Attendance for Class Credit, states that a student may not be given credit for a class unless the student is in attendance for at least 90 percent of the days the class is offered. The 90 percent attendance rule applies when determining VOE eligibility. Schools can accept decisions of attendance committees when considering VOE eligibility. Summer school does not count as make-up time for attendance purposes unless the attendance committee makes summer school attendance a part of a student’s plan to make up days missed. For students in grades eight and below, absences may be aggregated on the basis of a scholastic year. For students in grades 9-12, absences may be aggregated on the basis of a scholastic semester (traditional, condensed, accelerated,block, etc.). THE STUDENT SHOULD BE CONSIDERED ELIGIBLE FOR THE VOE FORM WHEN 1) the school considers the student currently enrolled at the time the student applied for the VOE forms AND 2) the school awarded a student credit for each class the semester prior to application for the VOE form OR the student was not awarded credit for each class the semester prior to application for the VOE form (academic failure). The school examines attendance records for the semester prior to application for the VOE form and determines that the student was present 90 percent of the time each class was offered OR the student was absent more than 10 percent and did not meet the 90 percent attendance rule for one or more classes the semester prior to application for the VOE form. The school attendance committee and/or administration approve a plan to allow the student to reinstate the credit for all classes. The student complies with the plan and credit for all classes the semester prior to application for the form is reinstated.

A student must meet one of the following requirements to receive the VOE form. The individual certifying attendance verifies onbehalf of the school, program, or institution the following as true and correct by marking the appropriate box and affixing a legal signature to this form.

Public, charter, home, or private schools: The public, charter, home, or private school should mark this box and issue the form to any student who is (1) currently enrolled (2) who met minimum attendance for class credit (90 Percent Rule) in each class they were enrolled in the fall or spring semester immediately preceding the date of application for the form.

GED programs: GED programs mark this box and issue the form to any student who (1) is currently enrolled, (2) has been enrolled in the program for a minimum of 45 calendar days, and (3) is meeting the attendance requirements prescribed by the GED program.

Institutions of higher education: Institutions mark this box and issue the form to students who have not obtained a diploma or its equivalent but are enrolled and attending as prescribed by the institution. Note: Institutions can issue a letter signed by an official of the institution stating that (1) the student is currently enrolled and (2) the student is meeting the institution’s attendance requirementsinstead of issuance of this form.

Typed or Printed Name of Student Date Student Signature

Typed or Printed Name and Title of Administrator/Designee

Area Code & Telephone

Issuance Date / /

Month Day Year

Administrator/Designee Signature

The VOE Forms issued during the school year (traditional, year round, etc.) expire 30 days from issuance. The VOE Forms issued the last 5 days of the school year expire the first day of the following school year.

Schools may personalize and/or develop their own VOE form provided all pertinent information contained on this form is incorporated.THE VOE DOCUMENT IS A GOVERNMENT RECORD AS DEFINED UNDER TEXAS PENAL CODE, 37.01(2). ANY MISREPRESENTATION BY THE APPLICANT OR PERSON ISSUING THE FORM MAY RESULT IN DENIAL OF AN APPLICATION FOR A TEXAS DRIVER’S LICENSE AND/OR CRIMINAL PROSECUTION.

Driver License Division

Appendix I

Behind-the-Wheel Instruction – Driver Education Affidavit

For Class C Provisional Driver License  

All information on this affidavit, except the signature, must be typed or printed in black ink. The signature must be written in black ink.

  

I, , valid driver license number , hereby certify that the(Instructor’s Legal Name) (Driver License Number)

 following information contained in this form is true and correct. I am the instructor of , who is at least

(Student’s Legal Name) 

16 years of age, whose date of birth is , and who has held a Texas learner license or a Texas hardship license for at least six months. (MM-DD-YYYY)

 I further certify that I am the parent, stepparent, foster parent, legal guardian, step-grandparent, or grandparent of the above named student; I have notbeen convicted of Criminally Negligent Homicide or Driving While Intoxicated; I have possessed a valid license for the preceding three years and my license has not been suspended, revoked, or forfeited in the past three years for traffic related violations.

 I further certify that I have instructed the above named student in the following Texas Department of Licensing and Regulation approved course of instruction (mark only one area of instruction):

 14 hours observation and in-car instruction – CONCURRENT with the remainder of the 32 hours of classroom instruction

Behind the Wheel Completion Date Classroom Completion Date

 14 hours observation and in-car instruction – BLOCK; and

  

My student completed 30 hours of guided practice which included at least 10 hours of nighttime driving by an instructor that meets the requirements of Section 521.222 (d) (2), Transportation Code.

  

Title of TDLR-Approved PTDE Training Course: Course Number:

Student’s Texas Learner License Number:

I acknowledge that falsely certifying the information contained in this affidavit will subject me to criminal penalties under Texas Transportation Code 521.454.

   

(Signature) (Date) 

 Sworn to and subscribed before me this day of , 20 .

   

(Notary Public in and for the State of Texas/Authorized Officer)  

NOTE: One affidavit is required for each instructor who taught a student in each phase of the course. If there is more than one instructor, this form may be photocopied for use by the other instructor(s). All instructors must accompany the student when applying for a provisional license. This affidavit must be signed either before a Driver License employee at the driver license office or before a Notary Public before coming to thedriver license office. The document(s) must be presented when the student applies for a provisional license. The definition of a qualified instructor can be found in the PTDE Information Packet.

  DL-90B (Rev. 8/15)

Help for the Teenager Who Wants to Drive 102

X

X

Form CDD-104 Revised 1/2006

School Name County-District-Campus No. (If Applicable)

Verification of Enrollment and Attendance (VOE) Form Planned Use of Data: To provide documentation of enrollment and attendance status to the Texas Department of Public Safety (DPS) for a student applying for an instruction permit and/or a license to operate a motor vehicle. The student presents the completed form to DPS. DONOT return this form to the Texas Education Agency. Authority: The Texas Transportation Code (TRC) requires students who have not obtained a high school diploma or its equivalent to be enrolled in a public, charter, home, or private school; GED Program; or Institution of Higher Education and meet specific enrollmentconditions to obtain or renew a license. This requirement applies to persons under 18 years of age. Contacts: Contact local DPS driver license office or DPS Headquarters website: www.txdps.state.tx.us and e-mail: pio@txdps.state.tx.us(512-424-2000) or Texas Education Agency website: www.tea.state.tx.us and e-mail: nina.saint@tea.state.tx.us (512-463-9574). Issuing VOE Forms: SEE flow chart for issuance at http://www.tea.state.tx.us/safedriver/voe04.html. The issuance or denial of the VOE form is strictly a local school, charter, GED program, or institution decision. Neither TEA nor DPS can alter a VOE decision. Schools,Charters, GED programs, and institutions of higher education can impose and enforce conditions and restrictions on enrollment andattendance as it pertains to VOE eligibility that exceed minimum restrictions defined by law and rule. It is recommended that schools, charters, GED programs, and institutions of higher education clearly outline all requirements for issuance of the VOE form and establish a formal, published policy to support the requirements. The VOE form does not have to be signed by the student in the presence of the person certifying attendance. The signature of the student can be placed on the form before or as it is presented to DPS. NOTE: Texas Education Code 25.092 (excerpted), Minimum Attendance for Class Credit, states that a student may not be given credit for a class unless the student is in attendance for at least 90 percent of the days the class is offered. The 90 percent attendance rule applies when determining VOE eligibility. Schools can accept decisions of attendance committees when considering VOE eligibility. Summer school does not count as make-up time for attendance purposes unless the attendance committee makes summer school attendance a part of a student’s plan to make up days missed. For students in grades eight and below, absences may be aggregated on the basis of a scholastic year. For students in grades 9-12, absences may be aggregated on the basis of a scholastic semester (traditional, condensed, accelerated,block, etc.). THE STUDENT SHOULD BE CONSIDERED ELIGIBLE FOR THE VOE FORM WHEN 1) the school considers the student currently enrolled at the time the student applied for the VOE forms AND 2) the school awarded a student credit for each class the semester prior to application for the VOE form OR the student was not awarded credit for each class the semester prior to application for the VOE form (academic failure). The school examines attendance records for the semester prior to application for the VOE form and determines that the student was present 90 percent of the time each class was offered OR the student was absent more than 10 percent and did not meet the 90 percent attendance rule for one or more classes the semester prior to application for the VOE form. The school attendance committee and/or administration approve a plan to allow the student to reinstate the credit for all classes. The student complies with the plan and credit for all classes the semester prior to application for the form is reinstated.

A student must meet one of the following requirements to receive the VOE form. The individual certifying attendance verifies onbehalf of the school, program, or institution the following as true and correct by marking the appropriate box and affixing a legal signature to this form.

Public, charter, home, or private schools: The public, charter, home, or private school should mark this box and issue the form to any student who is (1) currently enrolled (2) who met minimum attendance for class credit (90 Percent Rule) in each class they were enrolled in the fall or spring semester immediately preceding the date of application for the form.

GED programs: GED programs mark this box and issue the form to any student who (1) is currently enrolled, (2) has been enrolled in the program for a minimum of 45 calendar days, and (3) is meeting the attendance requirements prescribed by the GED program.

Institutions of higher education: Institutions mark this box and issue the form to students who have not obtained a diploma or its equivalent but are enrolled and attending as prescribed by the institution. Note: Institutions can issue a letter signed by an official of the institution stating that (1) the student is currently enrolled and (2) the student is meeting the institution’s attendance requirementsinstead of issuance of this form.

Typed or Printed Name of Student Date Student Signature

Typed or Printed Name and Title of Administrator/Designee

Area Code & Telephone

Issuance Date / /

Month Day Year

Administrator/Designee Signature

The VOE Forms issued during the school year (traditional, year round, etc.) expire 30 days from issuance. The VOE Forms issued the last 5 days of the school year expire the first day of the following school year.

Schools may personalize and/or develop their own VOE form provided all pertinent information contained on this form is incorporated.THE VOE DOCUMENT IS A GOVERNMENT RECORD AS DEFINED UNDER TEXAS PENAL CODE, 37.01(2). ANY MISREPRESENTATION BY THE APPLICANT OR PERSON ISSUING THE FORM MAY RESULT IN DENIAL OF AN APPLICATION FOR A TEXAS DRIVER’S LICENSE AND/OR CRIMINAL PROSECUTION.