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Youth Driver Training / Certification Program Application

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Applicant Information

Applicant Name *

Result will Mail

Applicant Age *

Applicant Address

Address Line 1

Address Line 2

City

State

Zip Code

EDGE&TA Branch #

Applicant Phone

Test 1

Instructor *

Test Result *

Pass
Fail

Test 2

Instructor *

Test Result *

Pass
Fail

Test 3

Instructor *

Test Result *

Pass
Fail

Test 4

(This test applies only if the student will be entering pulling competition or pulling other equipment.)

Will the student will be entering pulling competition or pulling other equipment.? *

Instructor *

Test Result *

Pass
Fail

Approved for Parade Tractor Pull

Make & Model of Tractor *

If the youth qualifies on more than -1- tractor, add them to list.

I understand my child will be operating a tractor/motorized vehicle at EDGE&TA shows and parades and will be responsible for his/her activities.

Parent or Sponsor Signature *

Clear Signature

Parent or Sponsor Printed Name *

Safety Officer Name *

Safety Officer Email *

Mail the card to

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

EDGE&TA Branch #

Submittor Information

Submittor Name *

Submittor Position *

Submittor Email *

Phone

Mail form to:
David Scibek
16300 CR 558
Farmersville TX, 75442

(972) 533-6440
[email protected]

(All cards will be mailed to the return address unless requested otherwise). Revised: August 7, 2014

This page was last modified: January 14th, 2024

All membership dues and lists are to be sent to the Secretary/Treasurer. Click on the Administration Page to find contact information for the officers.

All correspondence should be directed to the President, any questions should be sent to the Regional Director and all insurance questions to be sent to the Director handling insurance.

All EDGE&TA Membership Correspondence Should be Directed To: Tina Brown – EDGE&TA Secretary | [email protected] | , .