Official record of 30 hours of driving with parent or guardian
(This form should be on the reverse side of the Examiners’ Certificate copy to be official.)
Please keep track of the dates and the amount of time spent on each driving condition listed below. Complete the total time spent practicing each driving condition on the right and complete the total time spent practicing at the bottom. The total time spent practicing each driving condition must meet the minimum listed for each condition and the total time spent practicing must meet or exceed 30 hours.
| Driving Conditions | Date | Time | Date | Time | Date | Time | Date | Time | Date | Time | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Rural Highway Include passing maneuvers Minimum of 6 hours |
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| Rural Gravel Road Minimum of 4 hours |
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| Night Time Driving Minimum of 5 hours |
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| Residential Driving Include parallel parking, backing maneuvers, controlled and uncontrolled intersections Minimum of 9 hours |
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| Business District Driving Include controlled intersections and lane changes. Minimum of 6 hours |
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| Totals |
I hereby certify that I am the parent or legal guardian of this child, and that this child has completed a minimum of 30 hours of behind the wheel driving with a parent or guardian, and the 30 hours of behind the wheel driving included rural highway driving, rural gravel road driving, night time driving, residential driving, and business driving.
___ Parent ___ Guardian Date_____________ Signature_________________________
