DES135N - Driving Safety School Application - Texas Department of ...

DRIVING SAFETY SCHOOL APPLICATION INSTRUCTIONS

Each entity requesting to obtain or renew a Driving Safety School license shall provide an application for approval that shall be in compliance with 16 TAC Chapter 84 and Title 5, Education Code, Chapter 1001 and all TDLR established guidelines and criteria for a driver training school. HB 1560, TDLR's Sunset bill abolished driving safety schools as of June 1, 2023. A Driving Safety School license issued under Chapter 1001 of the Texas Education Code continues to be valid until June 1, 2023. A school application submitted after June 1, 2023 will be rejected.

1. Name of School ? Enter the assumed, legal or DBA name of the school.

2. License Application Type ? Select the type of application you are filing. Include School license number if submitting a renewal.

3. Organization Type ? Select the organization type for your business.

4. School Mailing Address ? Enter the school's mailing address, phone number, fax number, and email address. This address is where the Department will mail all correspondence and may be a post office box.

5. Contact Person Information ? Provide the contact person's name, telephone, number, and email address. Email addresses are a part of the key information required to transact business with TDLR. Your email address is confidential pursuant to the Texas Public Information Act and will not be shared with the public.

6. Course Provider Information ? Provide the course provider's name and license number.

7. School Physical Address ? Enter the physical address of the school. This address is the actual business location of the school and where permanent records must be kept for auditing and inspection purposes. A post office box is not acceptable for the physical address.

8. Owner's Information ? List the name, contact information and ownership information for each owner of the school.

9. Statement of Applicant ? Application must be signed by the owner, officer or other authorized individual.

Important Information: The Driving Safety School Multiple classroom form is to be completed if submitting a Renewal application. The Authorization to use Driving Safety Course form is required to be completed for both initial and renewal application types.

SEND YOUR COMPLETED APPLICATION AND REQUIRED DOCUMENTS TO:

Texas Department of Licensing and Regulation P.O. Box 12157 Austin, TX 78711-2157

Documents submitted with your application will not be returned. Keep a copy of your completed application, all attachments, and your check or money order. Do not send cash.

For additional information and questions, please visit the TDLR website at or reach the Education and Examination Division via webform where you can submit your request for assistance and include attachments as needed.

Review Process An application is not considered complete and will not be processed until all sections of the application have been completed and all documents have been received. Applications are processed in the order received. Our division cannot specify the length of time it will take to approve a school application. During the review process, you will be notified in writing of any discrepancies/requirements not met.

TDLR FORM DES135N rev July 2022

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DRIVING SAFETY SCHOOL APPLICATION

PLEASE NOTE: HB 1560, TDLR's Sunset bill abolished driving safety schools as of June 1, 2023. A Driving Safety School license issued under Chapter 1001 of the Texas Education Code continues to be valid until June 1, 2023. A school application submitted after June 1, 2023 will be rejected.

1. Name of School:

2. Application License Type: (select one)

Initial License $150.00 (Non-refundable fee) 3. Organization Type: (select one)

Sole Proprietor 4. School Mailing Address:

Partnership

License Renewal - License Number C $0.00

Corporation

Limited Liability

Number, Street Name, Suite Number, City, State, Zip Code

School Email Address

School Phone Number

5. Contact Person Information:

School Web Address

School Fax Number

Contact Person's Name

6. School Physical Address:

Phone Number

Email Address

Number, Street Name, Suite Number/Building Number, City, State, Zip Code

7. Course Provider Information:

Name 8. Owner information:

County

CP License Number

Business Name/Owner Name Mailing Address:

P.O. Box, Number, Street

Phone Number

Ownership % City, State, Zip Code Email Address

TDLR FORM DES135N rev July 2022

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8. Owner information: (continued)

Business Name/Owner Name Mailing Address:

P.O. Box, Number, Street

Phone Number Additional Owner Information: (if necessary)

Business Name/Owner Name Mailing Address:

P.O. Box, Number, Street

Phone Number Additional Owner Information: (if necessary)

Business Name/Owner Name Mailing Address:

P.O. Box, Number, Street

Phone Number

Ownership % City, State, Zip Code Email Address

Ownership %

Email Address

City, State, Zip Code

Ownership % City, State, Zip Code Email Address

9.

STATEMENT OF APPLICANT

By signing this application I certify that all information submitted on this application is true and accurate. I certify that I will comply with all applicable provisions of the law of the Texas Department of Licensing & Regulation (Title 5, Texas Education Code, Chapter 1001) and the rules of the Texas Department of Licensing & Regulation (16 Texas Administrative Code, Chapter 84). I understand that providing false information on this application and all attachments may result in the revocation of the approval I am requesting and the imposition of administrative penalties.

Signature of Owner, Officer, or Authorized Representative

Printed Name of Owner, Officer or Authorized Representative

TDLR Form DES135N rev July 2022

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Date Signed Title

AUTHORIZATION TO USE DRIVING SAFETY COURSE

This form is used by the course provider and driving safety school as verification of agreement. This form must be completed by the course provider and driving safety school. A course provider must submit written authorization to the department for each designated representative.

I,

(Name of Course Provider)

, provider for the driving safety course entitled

(

)

(Course Provider #) (Name of Course)

do affirm that the driving safety school listed below is authorized to offer this course at an approved driving safety school and all approved multiple classroom locations. The course provider has provided adequate course materials to present the course as it has been approved by the department.

(Typed or Printed Name of Driving Safety School Owner) (Legal Name of School)

(Street Address of School) (City)

(State)

(ZIP Code)

Method of Delivery

Traditional

Alternative Delivery Method

Signatures of the driving safety school owner and the course provider below indicate an agreement to conduct the course in compliance with all course provider policies and procedures. The school owner is aware of the course user fee (which includes the exact cost of the TDLR Certificate of Completion plus a minimum $3 fee) and the $25 minimum cost that must be charged for each student receiving instruction. The school owner understands that the authority to operate a driving safety school may cease if the course provider's license is denied, revoked, or expires.

(Signature of School Owner) (Signature of Course Provider or Designated Representative) TDLR Form DES135N rev July 2022

(Date) (Date)

DRIVING SAFETY SCHOOL MULTIPLE CLASSROOM LOCATIONS

INSTRUCTIONS: Use this form to notify TDLR when adding or removing multiple classroom locations.

The driving safety course will be provided in designated instructional areas that promote learning by ensuring that there is sufficient seating for the number of students, arranged so that all students are able to view, hear, and comprehend all instructional aids and the class shall have no more than 50 students. Factors that will be considered in determining whether facilities promote learning include facility layout, visual and hearing distractions, and equipment functionality. All designated instructional areas should be separated from the primary business (unless the class is being offered during non-business hours) and prohibit alcoholic beverages during class time.

Business Type Business Name

Business Address

Add Remove

TDLR FORM DES135N rev July 2022

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