Haman's New Drivers - Chattanooga, TN

Complete Form to Enroll

Class Information

Fall Break Monday - Thursday 9AM to 4:45PM: 10/13, 10/14, 10/15, and 10/16/2025 **NOTE: THESE DAYS ARE CLASS ONLY, IN-CAR DRIVING IS SCHEDULED AFTER THE 30 HOUR CLASS IS COMPLETED**

Student Information

First Name

Legal First Name

Middle

Last Name

Name Suffix

(Jr, II, etc.)

Street Address

Apt/Suite

City

State

Zipcode

Email

Student's Email

Phone

Date of Birth

Permit Number

Parent Information

Parent Name #1

Email

Phone

Parent Name #2

Email

Phone