Please Mail This Page To:

Atlantic Driving School

PO Box 5635

Mohave Valley, AZ 86446

928-330-2254  928-758-0651

Instructors: Gary & Glenda Webb

Class Date:_______________________

Driver Ed_____Traffic School_________

First & Last Name______________________________________________________________________

Street_________________________________________________________________________________

City & State____________________________________________________________________________

Phone number:_________________________________________________________________________

e-mail address_________________________________________________________________________

Credit Card #___________________________________________________________________________

Exp date_______________________________________________________________________________

Last 3 # on back of card_________________________________________________________________

Payments include payment plans. Checks, Money Order, Master Card/Visa.

Gift Certificates are available.

You MUST be paid in advance to drive.

Atlantic’s School cars are White 4-door

Nissan Versa-s.

Look for the yellow roof sign!