Home-Schooled In-Car Driver Education
HS 1 (07/26/2016)
Use this form to apply for authorization to conduct in-car driver education for your child. Pursuant to
Virginia Code § 22.1-205, the parent/legal guardian of a home-schooled minor may provide in-car instruction
to the child, provided the child meets the requirements for home school instruction under Virginia Code
§§ 22.1-254(B) or 22.1-254.1.
1. Complete this form in ink or type;
2. Attach a copy of either:
- The notification to the school division superintendent/designee of your intent to home-school the child,
- A letter from the school division superintendent/designee acknowledging that the child is home-
3. Attach the original proof of completion of the classroom portion of the driver education program;
NOTE: If your child is under age 18 in Planning District 8 (counties of Arlington, Fairfax, Loudoun, and
Prince William and the cities of Alexandria, Fairfax, Falls Church, Manassas, and Manassas Park), you
must also include form DEC 1 or form DTS 90 as proof of completion of the additional 90-minute parent/
student driver education component.
4. Mail this form and attachments to the Commercial Licensing Work Center at the address above.
STUDENT FULL LEGAL NAME (print) (last)
BIRTHDATE (mm/dd/yyyy) VA LEARNER'S PERMIT NUMBER
PARENT/LEGAL GUARDIAN FULL LEGAL NAME (print) (last)
PRINCIPAL RESIDENCE ADDRESS (street)
VA DRIVER'S LICENSE NUMBER
I request authorization to provide in-car instruction to my home-schooled child. I certify that the vehicle that will be used to provide training
is covered by an insurance policy that provides the minimum coverage as required by Virginia Code § 46.2-472 and I give consent to DMV
to review and monitor my driving record throughout the authorization period and until my child successfully completes the DMV
administered road skills test. I further certify and affirm that all information I have presented in this form is true and correct, that any
documents I have presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. 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/LEGAL GUARDIAN SIGNATURE