PFLUGERVILLE DRIVING SCHOOL
C-2568
Name:
City:
In Car Record
Address:
State:
Zip:
Student Phone#:
Parent(s) Name:
Permit #:
Permit Restriction Code(s):
Phone #:
Permit Issue Date:
Permit Expiration Date:
DOB ________
Drive Alone
Y
Scores: (+) = adequate knowledge of the skill, (0) = not addressed in this lesson
1 = 60% needs considerable practice, 2 = 70% minimally acceptable, 3 = 80% making progress, 4 = 90% good but continue
refining, 5 = 100% lesson skills mastered
Lesson 1: Beginning Driving/Basic Skills, Light City Driving
Date:
Time:
A/P
Drive:
hr
Pre-Drive check
Compartment operations
SIPDE
Right turn
Starting the car
Left turn
Braking, normal and emergency
Hand-over-hand control
Backing
Negotiating direction signals
Acceleration
Use of mirrors
Deceleration
Coordination of maneuvers: steering,
acceleration, braking
Instructor/license:
Observe:
hr
Score:
Entering traffic
Braking, emergency
Complete stops @ intersections
Lane and speed control
Observing Traffic controls
Parking
Securing parked vehicle
Parent Letter:
Y
N
Comments:
Lesson 2: Moderate City Driving
Date:
Time:
Pre-Drive check
SIPDE
Turns, right lane
Turns, left lane
Entering traffic
Tracking and lane centering
Mirror use
A/P
Drive:
Stopping distance, braking
Hand-over-hand control
Coordinating maneuvers
Speed control
Following distance
2 point turns
U Turns
hr
Instructor/license:
Observe:
hr
Score:
Lane changes
Perpendicular parking
Right of way rules
Observing road signs
Observing pavement markings
Lane choice
Skill confidence
Parent Letter:
Y
N
Comments:
Lesson 3: Moderate City Driving
Date:
Time:
Pre-Drive check
SIPDE
Entering traffic
Observing signs and lights
Turns, left lane
Angle parking
Perpendicular parking
Instructor/license:
Comments:
A/P
Drive:
Lane choice and control
Speed control
Following distance
Stopping distance, braking
Turns, correct lane
Stopping distance
Observing pavement markings
hr
Observe:
hr
Score:
Right of way rules
Controlled/Uncontrolled intersections
Right on red
Lane changes
Curb parking
3 point turns
Skill confidence
Parent Letter:
Y
N
N
Lesson 4: Rural and Highway Driving
Date:
Time:
Pre-Drive check
SIPDE
Observing signs and lights
Turns, left lane
Turns, left lane
Entering traffic
Constant speed control
A/P
Drive:
Lane choice and control
Speed control, following distance
Speed control, road conditions
Speed control, traffic conditions
Right of way rules
Lane changes
Stopping distance
hr
Observe:
hr
Score:
Shoulder parking
Emergency procedures
Observing pavement markings
Choosing passing opportunities
Overtaking other vehicles
Rail Road Crossing
Skill confidence
Instructor/license:
Comments:
Lesson 5: Freeway Driving
Date:
Time:
Pre-Drive check
Entering traffic
Observing signs and lights
Turns, left lane
SIPDE
Use of mirrors
Use of weave lane
Parent Letter:
A/P
Drive:
Lane choice and control
Speed control, following distance
Stopping distance, braking
Changing Lanes
Exiting the Freeway
Speed control entering and exiting
Speed control in turns
hr
Observe:
hr
Entering the Freeway
Right of way rules
Entering and Exiting
Lane changes
Passing/using passing lane
Skill confidence
Instructor/license:
Comments:
Parent Letter:
Lesson 6: Highway Driving and Parallel Parking
Date:
Time:
A/P
Drive:
Pre-Drive check
Right of way rules
Entering traffic
Speed control, following distance
SIPDE
Stopping distance, braking
Turns, left lane
Changing Lanes
Lane Choice and control
Right on Red
Space cushion
Checking blind spots
Observing signs and lights
Managing distractions
hr
Observe:
hr
PP - Backing
PP – steering control
PP – Curb parking
PP – Signal use
Rail Road crossing
Determining protected left
Skill confidence
Instructor/license:
Comments:
Parent Letter:
Lesson 7: Road Test (score of 2 or less requires a retest)
Date:
Time:
A/P
Drive:
Pre-Drive check
Lane choice and control
Entering traffic highway
Speed control
Observing signs and lights
Stopping distance
Turns, left lane
Changing Lanes
Turns, right lane
U Turns and
SIPDE
Smooth Braking
Parking
Observing signs
hr
Observe:
hr
Following distance
Right of way rules
Determining protected left
Right on Red
Three point turns
Emergency braking
Skill confidence
Instructor/license:
Comments:
Parent Letter:
Y
Score:
Y
Y
N
Score:
Y
Final Evaluation and Recommendations:
 No retest, but practice is needed
Date:
Instructor Signature
Date:
I certify that all minimum requirements for completion of the driver education course have been successfully completed.
Date
N
Score:
 Retest needed fee required ($50.00)
Student/Parent Signature:
School Director
N
N