DTSD I vorm Virginia
Virginia Autojuhtide Koolituse Lõpetamise Sertifikaat - Täiskasvanute Vabastamise Juhised
Kasutage seda dokumenti juhendina Virginia Driver Training Completion Certificate - Adult Waiver (DTS D) täitmiseks
DTS D I (02/10/2019)
Virginia Driver Training
INSTRUCTIONS
Completion Certificate (DTS-D)
Purpose: Use this document as a guide for completing the Virginia Driver Training Completion Certificate - Adult Traning (DTS-D).
NOTE:
The Virginia Driver Training Certificate is a three-part form - The Driver Training School (DTS) must print or type to enter
information to the form.
DRIVER INFORMATION
1. FULL LEGAL NAME:
2. BIRTHDATE:
Student's full legal name; no nicknames or abbreviations.
Student's date of birth (example: 07/11/1991).
CLASSROOM COURSE
(complete Classroom Instruction Attendance Roster (DTS 17) to record attendance)
1. SCHOOL NAME:
2. SCHOOL CODE:
Name of Driver Training School as it appears on DMV-issued license.
7-digit DMV number assigned to school.
3. TOTAL INSTRUCTIONAL
PERIODS:
Number of classroom instruction periods completed.
4. DATE COMPLETED:
Date student successfully completed instructional periods.
5. CLASSROOM INSTRUCTOR Classroom instructor prints full legal name, signs and dates certificate to acknowledge classroom
NAME, SIGNATURE, DATE: course completion.
NOTE: If student is going to complete in-vehicle instruction at another driver training school, the school that conducted the
classroom course instruction must complete a Certificate of Classroom Completion (DTS 36). Give the student the STUDENT
COPY of the DTS 36. Keep the DMV COPY and SCHOOL COPY in the student's file. The STUDENT COPY must be presented to
the school that will be conducting the in-vehicle course instruction as proof of classroom course completion before beginning
the in-vehicle course training.
IN-VEHICLE COURSE
(complete Student In-Car Instruction/Observation Record (DTS 14) to record training)
1. SCHOOL NAME:
2. SCHOOL CODE:
Name of Driver Training School as it appears on DMV-issued license.
7-digit DMV number assigned to school.
3. TOTAL DRIVING PERIODS:
4. MILES DRIVEN:
Number of driving periods completed.
Number of miles (must be at least 50 miles) student has driven with the instructor during the
in-vehicle course.
5. TOTAL OBSERVATION
PERIODS:
Number of periods student observed other adult driving.
6. DATE COMPLETED:
7. IN-VEHICLE INSTRUCTOR
LICENSE NUMBER:
Date student successfully completed in-vehicle course.
Number from instructor's valid license to teach.
8. IN-VEHICLE INSTRUCTOR
NAME, SIGNATURE, DATE:
In-vehicle Instructor prints full legal name, signs and dates certificate to acknowledge in-vehicle
course completion.
NOTE: If student completes classroom course instruction at another driver training school, he/she must present a DTS 36 as
proof of classroom course completion before beginning in-vehicle course instruction. The school that completes the in-vehicle
course instruction must transfer the classroom course completion information to the DTS D that will be completed by the
school that conducted the in-vehicle course instruction. Enter "Signature on File" in the area for classroom instructor
signature. Give the student the STUDENT COPY of the DTS D for their files and the DMV COPY to take to DMV.
STUDENT TRAINING CERTIFICATION STATEMENT
1. STUDENT NAME:
2. STUDENT SIGNATURE:
3. DATE:
Student must print his/her name as it appears on the DMV-issued learner’s permit or government-
issued document.
Student must sign his/her name as it appears on DMV-issued learner’s permit or government-issued
document.
Enter the date the certificate was signed.
INSTRUCTOR TRAINING CERTIFICATION STATEMENT
1. INSTRUCTOR NAME:
2. INSTRUCTOR SIGNATURE:
3. DATE:
The Instructor, classroom or in-vehicle, must print his/her name as it appears on the DMV-issued
instructor’s license.
The Instructor, classroom or in-vehicle, must sign his/her name as it appears on the DMV-issued
instructor’s license.
Enter the date the certificate was signed.
QUESTIONS?
Contact the DMV Commercial Licensing Work Center at (804) 367-7050.