SAMPLE | |||||
Service Agreement | |||||
School Information | Student Information | ||||
Name ____________________ | Name _______________________ | ||||
Address __________________ | Address _____________________ | ||||
Permit/License # | |||||
License # _________________ | of Student ___________________ | ||||
Phone # __________________ | Phone # _____________________ | ||||
This agreement between (Driving School Name) and (Student Name) will | |||||
include the following services: | |||||
Itemized Account | |||||
Services | Total Cost to Student | ||||
Purchase Permit at Agency (Paid to School) | ______________________ | ||||
Transportation to Law Knowledge and Vision Tests | ______________________ | ||||
Road Test Services | ______________________ | ||||
Instruction Services | # Lessons | # Min. Per Lesson | Cost Per | Total | |
Lesson | Cost of | ||||
Lessons | |||||
Behind The Wheel | _______ | _______ | _______ | _______ | |
Classroom | _______ | _______ | _______ | _______ | |
Grand Total Cost to Student | $_______ | ||||
This agreement must show an itemized account of any and all services rendered. In order to cancel a lesson and reschedule that lesson, 24 hours advance notice is required or the student may be charged for that lesson. Cancellation must be made at the phone number for the school listed above. Appointments must be mutually agreed upon for date, time and location.
The number of minutes per lesson specified shall be the actual number of minutes of instruction provided to the student. No more than three hours of behind-the-wheel instruction may be provided in any one calendar day. The only occupants of a driving school vehicle, other than a motorcycle, that is being operated on a public road or highway for purposes of the required six hours of behind-the-wheel driving instruction shall be the driving school instructor, the student who is receiving behind-the-wheel driving instruction and either a parent or legal guardian, an instructor-in-training or an instructor supervisor.
The vehicle to be used for instruction has: [ ] automatic transmission; [ ] standard manual gear shift; and shall be equipped with, at minimum, a brake for both the instructor and the student.
No fees will be charged other than those specified above.
This constitutes the entire agreement between the school and the student, or parent or legal guardian if the student is under 18 years of age, and no verbal statements or promises will be recognized. The student, or parent or legal guardian if the student is under 18 years of age, may rescind this agreement within 72 hours of the first lesson and upon such rescission shall receive a refund for any lesson or service not conducted or provided.
Signature Requirement | |
Date _________________ | Student Signature __________ |
or Legal Guardian | |
Date _________________ | Instructor's Signature ________ |
N.J. Admin. Code § 13:23-2.22
See: 16 N.J.R. 209(a), 16 N.J.R. 1354(a).
(b)7 added.
Repeal and New Rule, R.1991 d.371, effective 7/15/1991.
See: 23 N.J.R. 662(a), 23 N.J.R. 2151(a).
Former title "Contract file".
Amended by R.2010 d.080, effective 6/7/2010.
See: 41 N.J.R. 4408(a), 42 N.J.R. 1059(a).
In (a), substituted the second occurrence of "and" for "and shall advise all students of the availability of" and inserted the last sentence; and in the introductory paragraph of (d), inserted a comma following "contain" and "minimum" and rewrote the terms of the agreement.