Please review the checklist to ensure you have everything before you get started.

Teaching Parent’s Driver License Number
Student’s Driver License Number
Student completion certificate or final grade report as supplied by the course provider.
Copy of your completed driving log, that includes details on skills covered, deficiencies, and improvements made on each drive.

You will also have the opportunity to complete the driving log during the online submission if you do not have a legible copy to upload.

By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.

Parent Taught Driver’s Ed Form

Are you the student’s parent/legal guardian?

Yes

Parent is a father or mother of a child, whether by birth or adoption
Guardian is a person who is not the parent of a child, but who has been appointed by a court having jurisdiction over the child, to have a permanent self-sustaining relationship with the child and to make important decisions which have a permanent effect on the life and development of that child and to promote the general welfare of that child. A guardian may be a court. “Guardian” does not mean conservator.
Legal Custodian is a stepparent or a relative within the fourth degree of consanguinity to a child who has assumed responsibility for that child, a person who has accepted a release of custody pursuant to Iowa Code 232 subchapter IV, or a person appointed by a court or juvenile court having jurisdiction over a child

I am the student's:

Sorry, we cannot accept your application. The teaching parent must be the student’s parent/legal guardian.

Please review the parent requirements at https://iowadot.gov/mvd/driverseducation/Parent-taught.

Please review the checklist to ensure you have everything before you get started.

Teaching Parent’s Driver License Number
Student’s Driver License Number
Student completion certificate or final grade report as supplied by the course provider.
Copy of your completed driving log, you will also have the opportunity to complete the driving log during the online submission if you do not have a legible copy to upload.

Please make sure your driving log includes:

Complete date that includes the month, day, and year
Skills covered (be specific and detailed - view sample driving log)
Time each driving lesson occurred
Total driving time
Number of hours of night driving if the driving session included night driving
Notes on what was covered and any improvements or deficiencies that were made.

You will be required to upload the completion certificate and driving log. (Please note: Attachments must be attached as .pdf file)

Parent Taught Driver’s Ed Form

Parent 1 First Name

Parent 1 Middle Initial

Parent 1 Last Name

Address, City, State, ZIP Code

Parent 1 DL No.

Parent 1 Phone

Parent 1 Email

Parent First Name 2

Parent Middle Initial 2

Parent Last Name 2

Address, City, State, ZIP Code

Parent 2 DL No.

Parent 2 Phone

Parent 2 Email

Date of Birth

Driver License Number

Curriculum Acknowledgement

Please verify all curriculum requirements have been met.

I/We certify that:

I provided driver education instruction to my student that meets the requirements of Iowa Code 321.178A, Driver Education - Teaching Parent.

the above listed student successfully completed the following on-line course approved by the Iowa DOT:

the above listed student satisfactorily completed classroom instruction and at least 30 hours of street and/or highway driving, as required.

Copies of the following documents are attached and are true and correct:

Student final report as supplied by Course Provider including: Student's full name and address start and end dates of online program percentage of correct final exam answers and minimum passing percentage

Course Name and number

the student driving log (Iowa DOT Form 431228) with 30 hours of street or highway driving including 3 hours of driving after sunset and before sunrise

The following curriculum requirements were met:

4 hours of instruction concerning substance abuse

20 minutes of instruction concerning railroad crossing safety

instruction relating to becoming an organ donor under the revised Uniform Anatomical Gift Act as provided in Chapter 142C

instruction providing an awareness about sharing the road with bicycles and motorcycles

Do you have the approved course completion certificate?

Yes

STOP!

You must have the approved course completion certificate or grade report to proceed. Find out more about the certificate at https://iowadot.gov/mvd/driverseducation/parent-taught#Step2

Attachments must be attached as a .pdf file

Upload File(s): Please note you can upload more than one document at a time.

Click Here to Upload

Do you have a completed driving log?

Note: 30 hours of street or highway driving instruction including 3 hours night driving (sunset/sunrise) is required and needs to be reflected on your log.

Yes

Attachments must be attached as a .pdf file

Upload File(s): Please note you can upload more than one document at a time.

Note: 30 hours of street or highway driving instruction including 3 hours night driving (sunset/sunrise) is required and needs to be reflected on your log.

Please make sure your drive log includes details on skills covered, deficiencies, and improvements made on each drive.

Click Here to Upload

Please click Next to fill out the Driving Log information.

Driving Log

Note: 30 hours of street or highway driving instruction including 3 hours night driving (sunset/sunrise) is required and needs to be reflected on your log.

1. Date

1. Skills Covered

1. Start Time

1. End Time

1. Day Drive Time (in minutes)

1. Night Drive Time (in minutes)

1. Notes on deficiencies and improvements

2. Date

2. Start Time

2. End Time

2. Day Drive Time (in minutes)

2. Night Drive Time (in minutes)

2. Skills Covered

2. Notes on deficiencies and improvements

3. Date

3. Start Time

3. End Time

3. Day Drive Time (in minutes)

3. Night Drive Time (in minutes)

3. Skills Covered

3. Notes on deficiencies and improvements

4. Date

4. Start Time

4. End Time

4. Day Drive Time (in minutes)

4. Night Drive Time (in minutes)

4. Skills Covered

4. Notes on deficiencies and improvements

5. Date

5. Start Time

5. End Time

5. Day Drive Time (in minutes)

5. Night Drive Time (in minutes)

5. Skills Covered

5. Notes on deficiencies and improvements

6. Date

6. Start Time

6. End Time

6. Day Drive Time (in minutes)

6. Night Driving Time (in minutes)

6. Skills Covered

6. Notes on deficiencies and improvements

Total Drive Time:

Do you need additional logs? NOTE: 30 hrs of drive time is required, including 3 hrs of drive time after sunset or before sunrise.

Yes

Please click Next to fill out the Driving Log information.

7. Date

7. Skills Covered

7. Start Time

7. End Time

7. Day Drive Time (in minutes)

7. Night Driving Time (in minutes)

7. Notes on deficiencies and improvements

8. Date

8. Start Time

8. End Time

8. Skills Covered

8. Day Drive Time (in minutes)

8. Night Drive Time (in minutes)

8. Notes on deficiencies and improvements

9. Date

9. Skills Covered

9. Start Time

9. End Time

9. Day Drive Time (in minutes)

9. Night Drive Time (in minutes)

9. Notes on deficiencies and improvements

10. Date

10. Skills Covered

10. Start Time

10. End Time

10. Day Drive Time (in minutes)

10. Night Driving Time (in minutes)

10. Notes on deficiencies and improvements

11. Date

11. Skills Covered

11. Start Time

11. End Time

11. Day Drive Time (in minutes)

11. Night Driving Time (in minutes)

11. Notes on deficiencies and improvements

12. Date

12. Skills Covered

12. Start Time

12. End Time

12. Day Drive Time (in minutes)

12. Night Driving Time (in minutes)

12. Notes on deficiencies and improvements

13. Date

13. Skills Covered

13. Start Time

13. End Time

13. Day Drive Time (in minutes)

13. Night Drive Time (in minutes)

13. Notes on deficiencies and improvements

14. Date

14. Skills Covered

14. Start Time

14. End Time

14. Day Drive Time (in minutes)

14. Night Drive Time (in minutes)

14. Notes on deficiencies and improvements

15. Date

15. Skills Covered

15. Start Time

15. End Time

15. Day Drive Time (in minutes)

15. Night Driving Time (in minutes)

15. Notes on deficiencies and improvements

16. Date

16. Skills Covered

16. Start Time

16. End Time

16. Day Drive Time (in minutes)

16. Night Driving Time (in minutes)

16. Notes on deficiencies and improvements

17. Date

17. Skills Covered

17. Start Time

17. End Time

17. Day Drive Time (in minutes)

17. Night Drive Time (in minutes)

17. Notes on deficiencies and improvements

18. Date

18. Start Time

18. Day Drive Time (in minutes)

19. Date

19. Skills Covered

19. Start Time

19. End Time

19. Day Drive Time (in minutes)

19. Night Drive Time (in minutes)

19. Notes on deficiencies and improvements

20. Date

20. Skills Covered

20. Start Time

20. End Time

20. Day Drive Time (in minutes)

20. Night Drive Time (in minutes)

20. Notes on deficiencies and improvements

21. Date

21. Skills Covered

21. Start Time

21. End Time

21. Day Drive Time (in minutes)

21. Night Drive Time (in minutes)

21. Notes on deficiencies and improvements

22. Date

22. Skills Covered

22. Start Time

22. End Time

22. Day Drive Time (in minutes)

22. Night Drive Time (in minutes)

22. Notes on deficiencies and improvements

23. Date

23. Start Time

23. Day Drive Time (in minutes)

23. Night Drive Time (in minutes)

23. Notes on deficiencies and improvements

24. Date

24. Start Time

25. Date

25. Skills Covered

25. Start Time

25. End Time

25. Notes on deficiencies and improvements

Discaimer

Photos/documents uploaded during the submission process are not viewable until you receive your confirmation email.

37. Start Time

37. Skills Covered

37. Drive Time

37. End Time

37. Notes on deficiencies and improvements

38. Start Time

38. Skills Covered

38. Drive Time

38. Night Driving

38. Notes on deficiencies and improvements

38. End Time

39. Start Time

39. Skills Covered

39. Drive Time

39. Night Driving

39. Notes on deficiencies and improvements

40. Start Time

43. Start Time

43. Skills Covered

43. Drive Time

43. Night Driving

43. Notes on deficiencies and improvements

43. End Time

44. Start Time

44. Skills Covered

44. Drive Time

44. Parent's Initials

44. Notes on deficiencies and improvements

44. End Time

45. Start Time

40. Drive Time

40. Night Driving

40. Notes on deficiencies and improvements

40. Skills Covered

40. End Time

41. Start Time

41. Skills Covered

41. Drive Time

41. Night Driving

41. Notes on deficiencies and improvements

41. End Time

42. Start Time

42. Skills Covered

42. Drive Time

42.Night Driving

42. Notes on deficiencies and improvements

42. End Time

45. Drive Time

45. Night Driving

45. Notes on deficiencies and improvements

45. Skills Covered

45. End Time

46. Skills Covered

46. Start Time

46. End Time

46. Day Drive Time (in minutes)

46. Night Drive Time (in minutes)

37. Night Driving

46. Notes on deficiencies and improvements

39. End Time

24. Date

25. Date

25. End Time

25. Day Drive Time (in minutes)

25. Night Drive Time (in minutes)

25. Notes on deficiencies and improvements

26. Date

26. Skills Covered

26. Start Time

26. End Time

26. Day Drive Time (in minutes)

26. Night Drive Time (in minutes)

26. Notes on deficiencies and improvements

29. End Time