READ THIS FIRST

Texas Supplement to

Help for the Teenager

Who Wants to Drive!
Online Program

STEP BY STEP GUIDE

For 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 02/04/11
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 30 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.

2439 N. Union Blvd

Colorado Springs, CO 80909
1-800-942-2050
www.NationalDriverTraining.com
 Texas Quick Reference Checklist:
This checklist is designed as a quick reference only. 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 DPS using form DL 92

Study for Permit Test: Use the Driver Handbook, our practice permit test, and Level 1.
(6 hour minimum with no more than 2 hours per day)

Online students, complete the “Before you begin your program . . .” 3-step questionnaire on your
login-welcome screen to 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:
DPS form DL-91A (modified) Classroom Instruction Log Record showing
6 hours of study (online users download this form after completing “Before You Begin . . . ” questionnaire).
Completed VOE (Verification of Enrollment and Attendance in School form)
School ID or School Transcripts
The DL-90A Affidavit (completed and unsigned)
The License Application form (unsigned)
“Raised seal” birth certificate
Social Security card for your teen
Proof of Auto Insurance on your vehicle
DPS fee for the permit

Complete the Progam **You must obtain the permit before completing the program.**
Complete Level 1 Driving (step 6 of step-by-step guide)

Work through remaining 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 Driver License Packet which includes completed forms DL91A and B (step 7 of
step-by-step guide)

Obtain the License (step 8 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
Completed DL 91 A with 32 class hours
Completed DL 91 B with 50 driving hours
An up-to-date VOE Form
Driver Education Affidavit, DL 90-B
Your Valid Learners Permit
Pass a Driving Test at the DPS
 STEP-BY-STEP INSTRUCTION GUIDE - COURSE 102
Step 1: Verify that you have the proper course materials

NDT provides DPS approved course 102 in an online format with a variety of available upgrades. Your cus-
tomer 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 5 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 DPS

If you have not already sent the Request for a Parent Taught Driver Education Packet, Form DL-92 (included
at the end of this document), along with $20.00 to the Texas DPS in Austin, do so now (allow 3-6 weeks for
that packet). The DPS does not want you to start your driver education until you have received confirmation of
your registration with them. List names of both parents / legal guardians who will be teaching your teen on this
form. The DPS will enter your teen in their computer system and then they will send a certificate, DE 964, to
your local DPS office. Your local office will use the DE 964 certificate to open a file on your teen in preparation
for your teen’s permit test.

Step 3: The DPS Materials

You may begin tracking your teen’s study time once you receive verification of your registration with the Aus-
tin DPS. The DPS materials will include the Texas Driver Handbook, Application for Drivers License, and
information about the various courses approved in Texas. Please remove the License Application Forms and
the Texas Driver Handbook and retain them. You may set aside all other materials in the packet and 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: Study the Texas Driver Handbook and get your first 6 hours

Course 102 is a concurrent training program. Your teen must complete 6 hours of study before applying for a
permit. Have your teenager study the entire Texas Driver Handbook and fill any remaining time for the 6 hours
by taking the practice permit test or reading through Level 1. Remember, the state of Texas does not accept
more than 2 hours of study per day. Quiz your student on his knowledge of the Texas Driver Handbook us-
ing the questions located in the back of that Handbook. A copy of the Texas Driver Handbook is available for
download from our website.

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 online questionnaire is available on our welcome screen once your student logs in. Look
for the question, “Before you begin your program . . .” in large red letters and fill out the questionnaire online.
Once all three questions have been answered, you will get a link that says, “download your permit packet.”
Step 5: To the DPS for the Learners Permit

Collect the following documents to take to the DPS:

• DPS form DL-91A (modified) Classroom Instruction Log Record showing 6 hours of study.
• Completed VOE (Verification of Enrollment and Attendance in School form)
• School ID or School Transcripts
• The DL-90A Affidavit (completed and unsigned)
• The License Application form (unsigned)
• “Raised seal” birth certificate
• Social Security card for your teen
• Proof of Auto Insurance on your vehicle
• DPS fee for the permit
Your teenager will be administered the Texas Permit Test. The DE 964 Form was sent to the DPS office you
selected on your application to DPS Austin. 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

Once you have obtained the permit, 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 update class and driving time using the links in the program that say,
“Build your DL91A” and “Build your DL91B”. 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
“Driver License Pack” which includes your class and driving logs as well as a certificate for insurance purposes,
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
Once your DL91A and B forms are complete and you have completed all 7 levels online with passing test
scores, the parent may validate the teens hours by updating them on the last page of the online program. When
we have updated hours, test scores, and completed log forms, you may print off your “Driver License Pack” to
take 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 in a copy (keep your original for the DPS) to us if you want us to mail
you a certificate for insurance purposes. You may mail in the copy of your logs to:
National Driver Training
2439 N. Union Blvd
Colorado Springs, CO 80909

Step 8: Applying for the License

Take the following items with you to the DPS for the teen’s driver license:
• Completed DL 91A and B forms • Your Valid Learners Permit
• An up-to-date VOE Form • Proof of Insurance
• Driver Education Affidavit, DL 90-B • DPS fee for printing the driver’s license.
Important Texas Law Update
House Bill 339 is now law in Texas and went into effect September 1st, 2009. This law presents significant
changes for teen drivers. In summary, those changes are:

1. Texas law requires a minimum of 34 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 Texas license for the past three years
b. Must not have any felony driving convictions
c. Must have less than 6 points on their current driving record
d. 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 activities
b. No more than one passenger under age 21 who is not a family member
c. 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.
 How To Complete the DL 91A
Classroom 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 Texas DPS 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 CLASSROOM INSTRUCTION LOG RECORD

Not Valid Without Accompanying Receipt With Identical Student ID
will be able to download the DL Student’s Name Sheryl Har per Instructor’s Name Martyn Har per

91A with the proper fields filled Date Classroom Instruction Began January 2, 2010 Instructor’s Texas License Number 87654321

out for them by the computer. The Date Classroom Instruction Completed Course Number Course 102 Student ID: 50123

online questionnaire is available Texas DPS Approved Curriculum Utilized National Driver Training’s “Help for the Teenager Who Wants to Drive”
NOTICE: The classroom portion of the course may not be completed in less than 20 calendar days with a maximum
on our welcome screen once your of two hours of instruction in any one day.

student logs in. The student must

Module Minimum Hours Date of Instruction
Required Hours

answer three questions: 01/02/10

Hour 1

Module 1 / Level 1: Texas Driver Responsibilites - Knowing

Hour 2 01/02/10
Texas Traffic Laws. (Requires a thorough study of the Texas 6 Hours Hour 3 01/03/10
Driver Handbook and Help for the Teenager Who Wants to Drive (360 Minutes) Hour 4 01/03/10
Question 1 asks for the date that

E
Level 1 part 1).
Hour 5 01/04/10
Hour 6 01/04/10
the student began studying for the Module 2 / Levels 1 & 2: Texas Driver Responsibilites - Preparing
3 Hours
Hour 1
to Operate a Vehicle. (Level 1 - Familiarity with the vehicle, Hour 2
permit test. This date must be on Reference Points, Level 2 - Visibility)
(180 minutes)
PL
Hour 3

or after the date that the family

Hour 1
Module 3 / Level 2: Basic Maneuvering Tasks - Low Risk Driving 3 Hours
Hour 2
Environment (Level 2 - Sharing the Road, Right-of-Way) (180 minutes)

received confirmation of their Module 4 / Level 3 & 4: Basic Maneuvering Tasks - Moderate
Hour 3
Hour 1

registration with the DPS.

3 Hours
Risk Driving Environment (Level 3 - Traffic, Traffic Controls, Hour 2
(180 minutes)
Aggressive Drivers, Level 4 - Space Maintenance) Hour 3
Module 5 / Level 4: Information Processing - Moderate Risk 2 Hours Hour 1
Driving Environment (Level 4 - Navigation, Following Distance) (120 Minutes) Hour 2
Question 2 asks for the date that Module 6 / Levels 2 & 5: Information Processing - Complex Risk 2 Hours Hour 1
M
Driving Environment(Level 2 - Awareness, Level 5 - Adjust Speed) (120 Minutes)
the student finished the fourth hour
Hour 2
Hour 1

of study. For many students, this Module 7 / Levels 2, 3, & 7: Driver Performance - Personal
Factors (Level 2 - Distractions, Level 3 - Drivers impaired 6 Hours
Hour 2
Hour 3

is the date that they completed the physically, by illness, or drowsy, Level 7 - Alcohol, illegal drugs,
prescription drugs, OTC medicines)
(360 Minutes) Hour 4
Hour 5

Texas Driver Handbook. Hour 6

SA

Hour 1
Module 8 / Levels 5 & 6: Driver Responsibilites - Adverse 3 Hours
Hour 2
Conditions (Level 5 - Adverse Weather, Level 6 - Traction Loss) (180 minutes)
Hour 3
Question 3 asks for the date that Module 9 / Level 6: Driver Responsibilites - Vehicle Functions 2 Hours Hour 1
(120 Minutes)
the student completed the 6th hour
(Level 6 - Vehicle Technologies) Hour 2
Module 10 / Level 7: Driver Responsibilites - Making Informed 2 Hours Hour 1

of study. For some students, all 6 Choices (Level 7 - Vehicle Purchase, Insurance, Security)
Total
(120 Minutes)
32 hours
Hour 2

hours are spent in the Texas Driver (1920 Minutes)

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

Handbook. Other students may *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.
spend up to 2 hours in Level 1 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.

online. 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.
DL-91A Modified-Course 102
 How To Complete the DL 91A
Classroom 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 RECORD

Not Valid Without Accompanying Receipt With Identical Student ID
Student’s Name Sheryl Har per Instructor’s Name Martyn Har per

Date Classroom Instruction Began January 2, 2010 Instructor’s Texas License Number 87654321

Date Classroom Instruction Completed January 29, 2010 Course Number Course 102 Student ID: 50123

Texas DPS Approved Curriculum Utilized National Driver Training’s “Help for the Teenager Who Wants to Drive”
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 Hours Date of Instruction
Required Hours
Hour 1 01/02/10
Module 1 / Level 1: Texas Driver Responsibilites - Knowing
Hour 2 01/02/10
Texas Traffic Laws. (Requires a thorough study of the Texas 6 Hours Hour 3 01/03/10
Driver Handbook and Help for the Teenager Who Wants to Drive (360 Minutes) E Hour 4 01/03/10
Level 1 part 1).
Hour 5 01/04/10
Hour 6 01/04/10
Module 2 / Levels 1 & 2: Texas Driver Responsibilites - Preparing
3 Hours
Hour 1 01/06/10
to Operate a Vehicle. (Level 1 - Familiarity with the vehicle,
(180 minutes)
Hour 2 01/07/10
Reference Points, Level 2 - Visibility)
PL
Hour 3 01/08/10
Hour 1 01/09/10
Module 3 / Level 2: Basic Maneuvering Tasks - Low Risk Driving 3 Hours
Environment (Level 2 - Sharing the Road, Right-of-Way) (180 minutes)
Hour 2 01/10/10
Hour 3 01/12/10
Module 4 / Level 3 & 4: Basic Maneuvering Tasks - Moderate Hour 1 01/16/10
3 Hours
Risk Driving Environment (Level 3 - Traffic, Traffic Controls,
(180 minutes)
Hour 2 01/17/10
Aggressive Drivers, Level 4 - Space Maintenance) Hour 3 01/19/10
Module 5 / Level 4: Information Processing - Moderate Risk 2 Hours Hour 1 01/20/10
Driving Environment (Level 4 - Navigation, Following Distance) (120 Minutes) Hour 2 01/21/10
Module 6 / Levels 2 & 5: Information Processing - Complex Risk 2 Hours Hour 1 01/13/10
M

Driving Environment(Level 2 - Awareness, Level 5 - Adjust Speed) (120 Minutes) Hour 2 01/22/10
Hour 1 01/14/10
Module 7 / Levels 2, 3, & 7: Driver Performance - Personal
Hour 2 01/15/10
Factors (Level 2 - Distractions, Level 3 - Drivers impaired 6 Hours Hour 3 01/18/10
physically, by illness, or drowsy, Level 7 - Alcohol, illegal drugs, (360 Minutes) Hour 4 01/25/10
prescription drugs, OTC medicines)
Hour 5 01/27/10
Hour 6 01/28/10
SA

Hour 1 01/23/10
Module 8 / Levels 5 & 6: Driver Responsibilites - Adverse 3 Hours
Conditions (Level 5 - Adverse Weather, Level 6 - Traction Loss) (180 minutes)
Hour 2 01/24/10
Hour 3 01/25/10
Module 9 / Level 6: Driver Responsibilites - Vehicle Functions 2 Hours Hour 1 01/26/10
(Level 6 - Vehicle Technologies) (120 Minutes) Hour 2 01/24/10
Module 10 / Level 7: Driver Responsibilites - Making Informed 2 Hours Hour 1 01/29/10
Choices (Level 7 - Vehicle Purchase, Insurance, Security) (120 Minutes) Hour 2 01/30/10
Total 32 hours
(1920 Minutes) 01/30/10
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.
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.
DL-91A Modified-Course 102
 How To Complete the DL 91B
Behind-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 RECORD
Not Valid Without Matching DL 91A
Student’s Name Sheryl Har per Student’s Texas Instruction Permit Number 10987654

Instructor’s Name Martyn Har per Instructor’s Texas License Number 87654321

Course Number Course 102 Date Behind-the-Wheel Instruction Began January 5, 2010

Student ID 50123 Date Behind-the-Wheel Instruction Completed March 8, 2010

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, 1.1.1-1.1.6

Under 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)
E
In-Car Supervised
Practice 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 1 30 minutes

PL
Pre-Drive, Occpant Protection, Symbols, Devices
01/05/10 01/05/10
Starting, Vehicle Operation, Post-Drive 30 minutes 01/05/10 01/05/10
Module 3.2 / Level 2 60 minutes
Visual Attention, Communication, Reference Points
01/06/10 01/06/10
Vehicle Balance,Vehicle Manuevers 60 minutes
01/07/10 01/08/10
Module 4.2 / Level 3 60 minutes 01/16/10 01/16/10
Driving Practices, Fatigue, Aggresive Driving
60 minutes
Basic Maneuvers, Sharing Road w/Impaired Driver 01/17/10 01/18/10
Module 5.2 / Level 4 45 minutes
Risk Factors, Space Management,
01/20/10 01/20/10
M

45 minutes
01/20/10 01/21/10
Module 6.2 / Levels 3 & 5 60 minutes
Share the Road w/Pedestrian and Vehicle Traffic
01/19/10 01/19/10
Identify Conditions of Greater Risk 60 minutes
01/22/10 01/22/10
Module 7.2 / Level 5 45 minutes 01/23/10 01/23/10
Recognize/React to Distracted Drivers,
Drive in Areas of Moderate to Complex Risk 45 minutes
01/23/10 01/24/10
Module 8.2 / Level 5 45 minutes
SA

Vehicle Movement and Reference Points

01/24/10 01/25/10
Advanced Parking Maneuvers 45 minutes 01/25/10 01/26/10
Module 9.2 / Level 7 45 minutes
Comprehensive In-Car Progress Assessment
01/29/10 01/29/10
45 minutes 01/30/10 01/30/10
Module 10.2 / Level 6 30 minutes 01/27/10 01/27/10
Emergency Braking and Steering
30 minutes
Vehicle Safety Technologies 01/27/10 01/27/10
Total 7 hours 7 hours
01/30/10 01/30/10
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
 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 20 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 Cheryl Harper Student’s Texas Instruction Permit Number 10987654
Instructor’s Name Marilyn Harper Instructor’s Texas License Number 87654321
Course Number Course 102 Date Behind-the-Wheel Instruction Began January 6th, 2010
Student ID 50125 Date Behind-the-Wheel Instruction Completed March 8th 2010
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.)

Additional Beginning Dates Ending Dates Additional Beginning Dates Ending Dates
In-Car Supervised of additional of additional In-Car Supervised of additional of additional
Practice Completed In-Car Practice. In-Car Practice Practice Completed In-Car Practice. In-Car Practice
60 minutes 02/01/10 02/01/10 60 minutes 02/19/10 02/19/10
60 minutes 02/02/10 02/02/10 60 minutes 02/20/10 02/20/10
E

60 minutes 02/03/10 02/03/10 60 minutes 02/21/10 02/21/10

60 minutes 02/04/10 02/04/10 60 minutes 02/22/10 02/22/10
60 minutes 02/05/10 02/05/10 60 minutes 02/23/10 02/23/10
PL

60 minutes 02/06/10 02/06/10 60 minutes 02/24/10 02/24/10

60 minutes 02/07/10 02/07/10 60 minutes 02/25/10 02/25/10
60 minutes 02/08/10 02/08/10 60 minutes 02/26/10 02/26/10
60 minutes 02/09/10 02/09/10 60 minutes 02/27/10 02/27/10
60 minutes 02/10/10 02/10/10 60 minutes 02/28/10 02/28/10
M

60 minutes 02/11/10 02/11/10 60 minutes 03/01/10 03/01/10

60 minutes 02/12/10 02/12/10 60 minutes 03/02/10 03/02/10
60 minutes 02/13/10 02/13/10 60 minutes 03/03/10 03/03/10
60 minutes 02/14/10 02/14/10 60 minutes 03/04/10 03/04/10
60 minutes 02/15/10 02/15/10 60 minutes 03/05/10 03/05/10
SA

60 minutes 02/16/10 02/16/10 60 minutes 03/06/10 03/06/10

60 minutes 02/17/10 02/17/10 60 minutes 03/07/10 03/07/10
60 minutes 02/18/10 02/18/10 60 minutes 03/08/10 03/08/10
Total: 36 hours of additional in-car practice
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

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
 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)
• Texas Education Agency Verification of Enrollment and Attendance Form (for license)
 Mail Request Form and Fee To:
License Issuance Bureau REQUEST FOR A PARENT TAUGHT
Texas Department of Public Safety
PO Box 149246 DRIVER EDUCATION PACKET *462007*
Austin, TX 78714-9246 DL-92 (Rev. 4/07)
Please complete and submit with a $20.00 non-refundable fee (check or money order only) to the address in the top left corner. Aseparate request form and $20 non-refundable fee are required for each student who will be
participating in the Parent Taught Driver Education Program.
Program Eligibility Requirements
• 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 Texas driver license for the preceding three years; or if active duty 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 intoxicated. In addition, the instructor must not have had their driving privileges suspended, revoked or
forfeited for traffic related violations 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 instruc-
tion permit or provisional driver license will be denied and all prior classroom instruction or behind the wheel/in car instruction providedby 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.
The instructor may go to any local Driver License office to have the student apply for the license and take the required test.
NOTE: ALLINFORMATION AND REQUIRED FEE MUST BE SUBMITTED BEFORE A PARENT TAUGHT DRIVER EDUCATION PACKET WILL BE MAILED. PLEASE ALLOW 2-3 WEEKS FOR DELIVERY.
Please print or type in black ink. This form is read by machine; please print the numbers and letters as shown below:

1 2 3 4 5 6 7 8 9 0 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Instructor’s Information (Parent or Legal Guardian). The Parent Taught Driver Education Packet will be mailed to the address below.
First Name

Last Name

Mailing Address

City State Zip Code

Daytime Telephone Number (include area code)

– –
Student’s Information. Complete the legal name for the student.
First Name

Middle Name

Last Name

Suffix (Jr., Sr., etc.) Date of birth

M M D D Y Y Y Y

See other side for additional

Instructor’s Signature Date qualifying information
DL-14A (Rev. 9/09)

APPLICATION FOR TEXAS DRIVER LICENSE FOR DEPARTMENT USE ONLY

OR IDENTIFICATION CARD RESTRICTIONS/ENDORSEMENTS
NOTICE: All information on this application, except the signature, must be
TYPEWRITTEN or PRINTED in BLACK INK. The signature shall be WRITTEN in
BLACK INK. ONCE THIS APPLICATION FORM AND FEE HAVE BEEN SUBMITTED,
NO REFUNDS WILL BE MADE. Applications held only 90 days. ASSIGNED #

APPLICATION for: DRIVER LICENSE COMMERCIAL DRIVER LICENSE (CDL) (Circle Class Desired)
LEARNERS LICENSE IDENTIFICATION CARD CLASS
NON-RESIDENT COMMERCIAL DRIVER LICENSE A B C M

APPLICANT INFORMATION CONTACT INFORMATION

LAST NAME: HOME PHONE:
FIRST NAME: OTHER PHONE:
MIDDLE NAME: EMAIL:
SUFFIX:
ADDRESS INFORMATION
MAIDEN NAME:
RESIDENCE ADDRESS: (in line below)
DATE OF BIRTH:
— —
CITY: COUNTY:
SOCIAL SECURITY NUMBER:
STATE: ZIP CODE:
— —
COUNTRY:
SEX: MALE FEMALE
MAILING ADDRESS:
EYE COLOR: HAIR COLOR:
RACE: HEIGHT: ft. in.
CITY: STATE:
WEIGHT: LBS.
ZIP CODE: COUNTRY:
UNITED STATES CITIZEN: yes no
PLACE OF BIRTH: CITY: COUNTY: STATE: COUNTRY:
FATHER’S LAST NAME: MOTHER’S MAIDEN NAME:

REQUIRED INFORMATION FROM ALL APPLICANTS:

YES NO
1. Do you wish to donate $1.00 to the Blindness Education Screening and Treatment Program?
2. Do you wish to donate $1.00 to the Glenda Dawson Donate Life – Texas Registry?
Would you like to register as an organ donor?
Do you consent to the release of your name, date of birth, driver license number and recent address to the statewide internet-based
registry of organ, tissue and eye donors and for release to qualified organ, tissue and eye bank organizations?
3. Do you have a health condition that may impede communication with a peace officer? If yes, Please list
(must complete form DL-101)
4. Would you like to complete a voter registration application form today? You must be eligible.
(¿Le gustaria llenar la forma de registro de votante hoy? Tiene que ser elegible.)
5. Have you ever had a Texas identification card? Number When?
6. Have you ever had a driver license or instruction permit in Texas? Number When?
7. Have you ever had a license or instruction permit in any other state? List State(s)
Number(s) When?

REQUIRED INFORMATION FROM DRIVER LICENSE APPLICANTS:

YES NO DRIVING HISTORY INFORMATION
8. Are you enrolled in or have you completed an approved driver education course?
9. 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
10. Do you own a motor vehicle which is required to be registered (Texas Transportation Code Section 502.002)?
11. 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)?

APPLICATION CONTINUED ON BACK

FOR DEPARTMENT USE ONLY
DOCUMENT PRESENTED: DOCUMENT NUMBER: ISSUING AGENCY:
DOCUMENT PRESENTED: DOCUMENT NUMBER: ISSUING AGENCY:
DOCUMENT PRESENTED: DOCUMENT NUMBER: ISSUING AGENCY:
DOCUMENT PRESENTED: DOCUMENT NUMBER: ISSUING AGENCY:
DOCUMENT PRESENTED: DOCUMENT NUMBER: ISSUING AGENCY:
DRIVER LICENSE APPLICANTS
The answers to questions 1 through 7 below are for the confidential use of the Department
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?

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 the driving privilege. False
information could also lead to criminal charges with penalties of a fine up to $4,000.00 and/or jail.

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

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.
I further certify my residence address is a : ( ) single family dwelling, ( ) apartment, ( ) motel, ( ) temporary shelter. (check one)
I agree to immediately report to the Texas Department of Public Safety any changes in my medical condition which may affect my ability to safely
operate 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

Pursuant to Texas law, the Texas Department of Public Safety will 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 system, and the implied consent law. The minor applicant and the cosigner must acknowledge receipt of that information prior to
issuance of any driver 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

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 Department
of Public Safety to issue a Class ( ) A, ( ) B, ( ) C, or ( ) M license to said minor.

Usual Written Signature of Parent or Guardian Driver License Number Date

WAIVER OF PARENTAL AUTHORIZATION

Parental Authorization waived. Authority DL Employee #

VERIFICATION

Sworn to and subscribed before me this day of ,

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

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 informa-
tion 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 account 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 and the
Texas Secretary of State for statutorily authorized purposes pursuant to Texas Transportation Code Section 521.044.
State of Texas
County of ________________

CLASSROOM INSTRUCTION - DRIVER EDUCATION AFFIDAVIT

(For Class C Learner License)

(All information on this affidavit, except the signature, must be TYPEWRITTEN or PRINTED in BLACK INK. The signature must be
written in BLACK INK.)

I, __________________________________________________, valid Texas driver license number _______________________,

(Instructor’s Legal Name)

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

_____________________________________________________,
(Student’s Legal Name)

whose date of birth is ________________________, thereby meeting the age requirement to obtain a Class C Learner License.
(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;
that I possessed a valid driver license for the preceding three years; that I have not been convicted of Criminally Negligent Homicide or Driving
While Intoxicated; that I have not had my driving privileges suspended, revoked or forfeited in the past three years for traffic-related violations; and
that I am not disabled because of mental illness.

I further certify that I have instructed my student in the following Texas Department of Public Safety approved course of instruction:
(mark only one area of instruction)

‰ 32 hours of classroom instruction under the BLOCK program

‰ 6 hours of classroom instruction under the CONCURRENT program

Help for the Teenager Who Wants to Drive

Title of Texas DPS Approved PTDE Training Course used ______________________________________________
102
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.

PLEASE NOTE: One affidavit is required for each instructor who actually 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 Texas Department of Public Safety 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 instruction packet.

FOR DPS USE ONLY

Texas Driver Education Certificate, form DE-964, #________________________________
DL-90A (Rev. 10/08)
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. DO
NOT 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 enrollment
conditions 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 and
attendance 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 on
behalf 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 requirements
instead of issuance of this form.

Typed or Printed Name of Student Date Student Signature

Typed or Printed Name and Title of Area Code & Issuance Date Administrator/Designee Signature
Administrator/Designee Telephone / /
Month Day Year

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.

Form CDD-104 Revised 1/2006

State of Texas

County of ______________________

BEHIND THE WHEEL INSTRUCTION - DRIVER EDUCATION AFFIDAVIT

(For Class C Provisional Driver License)
(All information on this affidavit, except the signature, must be TYPEWRITTEN or PRINTED in BLACK INK. The signature must be written in BLACK
INK.)

I, ________________________________________, valid Texas driver license number ______________, hereby certify that the following
information
(Instructor’s Legal Name)

contained in this form is true and correct. I am the instructor of, ____________________________________________, who is at least 16 years of
age,
(Student’s Legal Name)

whose date of birth is ______________, and who has held a Texas learner license or a Texas hardship license for at least six (6) 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
not been convicted of Criminally Negligent Homicide or Driving While Intoxicated; I am not disabled because of mental illness; and 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 Public Safety approved course of instruction:
(mark only one area of instruction)
‰ 7 hours Behind-the-Wheel and 7 hours In-Car Supervised Practice instruction – CONCURRENT with the remainder of the 32 hours of
Classroom instruction
‰ 7 hours Behind-the-Wheel and 7 hours In-Car Supervised Practice instruction -BLOCK
Help for the Teenager Who Wants to Drive
Title of Texas DPS APPROVED PTDE Training Course used ______________________________________________________
102
Course Number: ____________

The student’s Texas Learner License # _______________________

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

PLEASE NOTE: One affidavit is required for each instructor who actually 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 Driver 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 Texas Department of Public Safety Driver License Office. The document(s) must be presented when the student
applies for a Provisional Driver License. Definition of a qualified instructor can be found in the instruction packet.

FOR DPS USE ONLY

Texas Driver Education Certificate, form DE-964, #_________________________________

DL-90B (Rev. 10/08)

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. DO
NOT 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 enrollment
conditions 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 and
attendance 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 on
behalf 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 requirements
instead of issuance of this form.

Typed or Printed Name of Student Date Student Signature

Typed or Printed Name and Title of Area Code & Issuance Date Administrator/Designee Signature
Administrator/Designee Telephone / /
Month Day Year

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.

Form CDD-104 Revised 1/2006