Form Dts 62 - Parental Consent For Online Driver Education Examination
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1Virginia Driver Training
DTS 62 (10/14/2016)
PARENTAL CONSENT FOR ONLINE
DRIVER EDUCATION EXAMINATION
Purpose:
Use this form to give consent for students under age 18 to take the online drivers education examination at
the driver training school that offered the online course.
Instructions:
The student’s parent/guardian must complete this form. The completed form must be submitted to the DMV-
licensed driver training Instructor at the test site prior to taking the examination.
STUDENT INFORMATION
STUDENT FULL LEGAL NAME (print)
(last)
(first)
(middle)
(suffix)
BIRTH DATE (mm/dd/yyyy)
STREET ADDRESS
CITY
STATE ZIP CODE
TEST SITE INFORMATION
SCHOOL NAME
SCHOOL STREET ADDRESS
CITY
STATE ZIP CODE
SCHOOL PHONE NUMBER
SCHEDULED TEST DATE
(
)
PARENT/GUARDIAN SIGNATURE
By signing this form, I give consent for my child to take the online driver’s education examination at the driver training school
that offered the online course. I understand that the examination will be administered and monitored by a DMV-licensed
Instructor. I understand that my child must present an acceptable form of identification prior to being allowed to take the test.
DMV acceptable identification documents include:
DMV issued Learner's Permit/Identification Card
Passport
l
l
School ID
Government issued ID
l
l
Failure to present proper identification will result in my child not being allowed to take the final examination. I certify and
affirm that all information presented in this form is true and correct. I make this certification and affirmation under penalty of
perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.
PARENT/GUARDIAN NAME (print)
PARENT/GUARDIAN SIGNATURE
DATE (mm/dd/yyyy)
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