Defensive Driving Academy - Senior Registration Form

^{...excellence requires a coach!}

Senior Reg Form

DDA ACCEPTS ALL MAJOR CREDIT CARDS:

What are People saying about DDA?

"Jerry, Hey thanks for teaching Nicole not just the right way to merge onto the highway, but what to do when things get tricky. Yeah, I would have never thought to teach her that technique, but now I know what you meant when you said driving program vs. defensive driving program...

and by making her a right-of-way expert, her decision-making and confidence are so much better. You guys were great!! I'll be sure to tell everyone about DDA"
~Donna M - Villanova

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Take a Free

PA Permit Test

Once your registration form is submitted, a DDA Representative will contact you to answer any remaining questions and/or schedule your Senior Session. Payment is not required to register, but please let us know what payment method you prefer below.

Please DO NOT submit while using smart phone or tablet

Senior's Information
First Name:
Last Name:
Gender:
Age:
Street Address:
Apt / Floor:
Apt Complex Name (if any):
City:
Zip Code:	(5 digits)
Home Phone:
Cell Phone:
Work Phone:
Email:
DOB:
Drive Style:
Licensed how long?	(Appx)
Accidents or points?
Last drive was?	(Appx)
Alt/Family Contact Information
Alt Name:
Relationship:
Alt Home Phone:
Alt Cell Phone:
Alt Work Phone:
Alt Email:
Lesson Preferences
Best Time:
Best Day:
Scheduling Comments:
Program Information
Reason Requested:
Payment Options:
**ONLINE PAYMENTS	Must print or save a copy of the receipt at checkout to show your DDA Coach before each lesson can begin. Tip: Keep with PA Permit
Other Information
A DDA Rep should:
Best phone # to call:
Referred by:
I filled out this Reg form using:
Any Scheduling, Driving, Learning or Medical Comments or Concerns can be typed here:	Have you read the FAQs Page ?
I have read and agree to DDA's Cancellation Policy/Terms	DDA, INC. CANCELLATION POLICY/TERMS: Behind-the-Wheel Driving lessons and Test dates are not ongoing (like work, school, etc.), but rather, a very limited educational/business commitment that should be prioritized above your other re-occurring activities, practice or jobs. When a student cancels an appointment with short notice, DDA Coaches must still be paid, so please provide us with as much notice as possible. Same-day cancellations are subject to a $40 fee. No-shows are subject to the full cost of the lesson and will only be rescheduled with approval from the program Director. To cancel an appointment with less than 24 hrs notice or if it's after 12pm on a Friday (for weekend cancellations) DO NOT SEND AN EMAIL! Please call 610 353-2047 and press option 2. Sending an email in this situation might not be received, therefore, the aforementioned cancellation fees will be assessed. Additionally, repeat cancellations, inappropriate or offensive behavior, voicemails or emails will not be tolerated, and DDA Inc. reserves the right to dismiss students at anytime if necessary.

Please DO NOT submit while using smart phone or tablet -
form may seem to submit properly but we will not receive it

Take a Free Practice PA Permit Test If you haven't been to the DMV to get your learner's permit, or you've been there a few times and had difficulty passing the computer knowledge test--it's okay. DDA is here to help!!! Just click on the PA Driver's Manual (to the left), and you can take a 25 question practice permit test which is very similar to the PA test. If you feel you need more practice questions, just Google "free PA permit test" and you can keep trying practice questions until you're ready to pass the real thing--GOOD LUCK!!!!