Home Phone
£M
£F
ZIP Code
Time your school
day ends
Cell Phone Number
or Saturday morning at: £ 7:30am £ 9am £ 10:30am £ 12 noon
222-05 56th Avenue
Bayside, New York 11364-1497
OFFICE OF CONTINUING EDUCATION
NONPROFIT
U.S. POSTAGE
PAID
FLUSHING, N.Y.
PERMIT NO. 520
APPLICATION
Fall 2015
Parent Signature_______________________________________________________________ Date________________________________________
CONSENT: I certify that I am the parent or legal guardian of _____________________________________________________ and hereby grant him/her
permission to enroll in the Queensborough Community College Driver Education Course.
LECTURE: After school hours on: £ Thursday 5-6:30pm or Saturday morning at: £ 9am £ 10:30am
NOTE: Full payment of $580 must accompany application.
DRIVING: After school £ Monday £ Tuesday £ Wednesday £ Thursday £ 3:30-5pm £ 5-6:30pm
Driving schedules are subject to change and must be confirmed by course director. For driving, indicate choice (1) and choice (2). You will
receive instructions by return mail.
School Attending
Town
Legal First Name
Parent’s Business Phone
M.I.
SCHEDULE PREFERENCES CHART (Times are approximate)
Email Address
Date of Birth
Address
Name (Last)
FORM A
DRIVER EDUCATION
PROGRAM
Accredited and Registered by the
New York State Board of Regents
The Office of Continuing Education
Queensborough Community College
06/2015 685-15
222-05 56th Ave., Bayside, NY 11364-1497
Register early to avoid disappointment!
Credit Card: £ VISA £ MasterCard £ Am Ex £ Discover
Exp. Date____________ Card No.____________________________________
V Code (additional 3 or 4 digit code found on back of credit card) ______________
Check/Money Order No.________________________
PAYMENT: Cash accepted at Bursar’s Office only (see office hours). Keep all receipts.
*In person ONLY: £ Cash
£ Check £ Bank Check £ Money Order
Registration Fee $ 20
Total Payment $ 580
Tel: 718-631-6343
Fax: 718-281-5538
Make checks payable to: Queensborough Community College
Mail to: Office of Continuing Education, Room L-118P
Queensborough Community College, Bayside, NY 11364-1497
Payment Only $ 560
Driver Education Tuition – Full
D E X - 1 0 0
Student’s Social Security No.
Card/Check Payer’s Name:
)
Cell Phone (
)
Day Phone: (
)
Evening Phone: (
City:State:ZIP:Email:
Address:Birth Date:
First Name:
Last Name:
CONTINUING EDUCATION REGISTRATION FORM—QUEENSBOROUGH COMMUNITY COLLEGE
£M
£F
£££-££-££££
FORM B
Eligibility. All high school students are eligible to register
for the Driver Education program provided they are or
will be 16 years of age by September 10, 2015. You must
have a Learner’s Permit or Junior License before the first
class.
LOCATION
Office of Continuing Education, Room L-118P
Queensborough Community College 222-05
56th Ave. (near Springfield Blvd.), Bayside, NY
Telephone: 718.631.6343 Fax: 718.281.5538
Objectives
• Acquire safe driving skills and defensive driving
awareness.
• Earn the MV 285 “Completion Certificate,” providing
eligibility for 10% to 15% discounts on insurance
premiums with most companies; Duplicate cards, $25.
• Qualify those who successfully complete the course to
apply for senior driver’s license at age 17.
DIRECTIONS TO THE COLLEGE
The campus is easily accessible by car from all parts
of Queens and Long Island. It is just a few blocks north
of the Springfield Boulevard exit on the Long Island
Expressway, and immediately south of the Northern
Boulevard exit on the Cross Island Parkway.
TUITION AND FEES. Tuition is $580 (does NOT include
textbook cost of $45). Full tuition must accompany your
application/registration — see attached Forms A and
B. (Additional fees, not payable to QCC, include learner’s
permit and optional road test service fee.)
FALL 2015 SCHEDULE
Classes start: Thursday, September 17, 2015;
Classes end approximately Saturday, January 30, 2016.
REGISTRATION
1. T
o reserve a place, complete Form B (attached) and
include $575 tuition. Partial payment not accepted.
2. Complete both Form B (registration) and Form A
(application).
3. Make checks payable to QCC, or pay by VISA/
MasterCard/Am Ex/Discover or money order.
5. Y
ou may register by mail, by fax (718.281.5538), or in
person.
Office Hours (Library Bldg., Rm 118P):
Monday-Friday, 9 am - 5 pm
This program is an introduction to driving; additional
practice outside of class will be needed.
REFUND POLICY
• 90% of total tuition fee will be refunded if requested in
writing prior to first class.
• No refunds after classes have begun.
SUBWAY AND BUS ROUTES TO QUEENSBOROUGH
From Flushing
Take Main Street Flushing Line (No. 7) to Main Street
Flushing Station. Take Q27* bus to Springfield Blvd. and
56th Ave. Walk east to campus.
From Jamaica
Take F train to 169th St. and Hillside Ave., then the Q30
bus via Horace Harding Blvd. to Springfield Blvd. Walk
north to 56th Ave. and turn right to campus. You can
also take the E, J, or Z trains to Sutphin/Archer station,
then the Q30 bus from there.
From the Bronx
Take the Q44 bus to Main Street, Flushing. Transfer
to the Q27* bus and proceed to Springfield Blvd. and
56th Ave.
From Nassau County
The N-20, N-21 bus line from Nassau County stops at
the corner of Northern Blvd. and 223rd St. (Cloverdale
Blvd.). The bus makes stops in the towns of Glen Cove,
Roslyn, Manhasset and Great Neck.
Via City Bus from Queens high schools
• From Francis Lewis H.S., take Q30 to Springfield Blvd.
• From Bayside H.S., take Q31 to 48th Ave. and
transfer to Q27*.
• From Van Buren H.S., take Q27* along Springfield
Blvd.
• From John Bowne H.S., take Q88 to 73rd Ave. and
Springfield Blvd., and transfer to Q27*.
* The Q27 bus stops on the campus on weekdays only
(Mon. - Fri.)
The City University of New York/QCC is an EEO/IRCA/ADA employer. All
AA/EEO policies/procedures are at: www.qcc.cuny.edu/AffirmativeAction