Fillable Printable Form 661001
Fillable Printable Form 661001
Form 661001
For Department use only
Prelicensing inspection req met
Status: Denied Approved ByLicense no Expiration
Driver Training School
License Application
Use this form to apply for or renew a driver training school license. Send the
completed application, any required attachments, and the nonrefundable fee
in a check or money order payable to the Department of Licensing to:
Driver Training Schools, Business and Professions Division,
Department of Licensing, PO Box 3907, Seattle WA 98124-3907.
This license application is for:(check one)
Main school - initial application – $500
Main school - renewal application – $250
(also complete Renewal Questionnaire, page 3)
Purchase of existing school - application – $500 (attach sales agreement)
Enter number of staff or non-instructor owners: x $12 = Include this amount with your application fee for
the Washington Access to Criminal History (WATCH).
Fingerprints:Owners, instructors, and staff who have regular unsupervised contact with students, have access to the
school portal, or who are involved in testing must be fingerprinted for state and national background checks. Each person
must go to www.identogo.com to schedule an appointment at an IdentoGO location of MorphoTrust, our electronic
fingerprinting vendor. For more details go to www.dol.wa.gov/business/fingerprinting.html.
Applicant information
Name of school (as you would like it to read on your license)School license number (renewals only)
Physical address (Street, City, State, ZIP code)
County
Mailing address, if different (no residential addresses)
(Area code) Phone # at this location (Area code) Fax # at this location Name of on-site manager at this location Main school email
Type of business
Owner (sole proprietor) Partnership LLC Corporation Other
Washington Unified Business Identifier (UBI) number Employer identification number (EIN)
For informational purposes only.This is not a requirement.
Are you certified through OMWBE? Yes No
Location change (if applicable)
Existing location
Street address and city
New location
Street address and city
Owners/ Interest holders information– List all owners, partners, associates, corporate officers, and
substantial interest holders (i.e., someone who owns the instruction vehicles other than the owner, excluding financial
institutions). If business is a sole proprietorship, do you want a spouse listed as an owner? Adding them later may require
a new application and fees. Attach additional sheets, if needed.Failure to disclose owner information may result in
license denial or suspension.
Name Position (Area code) Phone #
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Owners/Interest holders information(continued)
Answer the following
1.Has any officer, director, stockholder, partner, or any person directly or indirectly interested in your
school ever been convicted of a gross misdemeanor or felony? ................................ Yes No
2.Are there any civil actions now pending against this business or any member, directly or indirectly,
involved in this school? ............................................................... Yes No
Attach a list of all staff and instructors who are employed by your school.
Location– attach a copy of current lease including any amendments made since the last renewal
1.Is the school or branch located at least 1,000 feet or more away from any Department of Licensing
office where examinations for driver licenses are conducted?.................................. Yes No
2.Is the school or branch located in a district zoned for business or commercial purposes and in a
building space used exclusively for giving driver education? (If yes, attach a lease agreement copy.) ... Yes No
3.Is the branch located in a high school? (If yes, attach copy of the school district agreement.) ......... Yes No
Insurance – Proof of automotive liability insurance must show coverage of at least one million dollars, and must include
property damage and uninsured motorists coverage. If testing, you also must have professional liability coverage.Attach a
copy of the policy or binder showing the required coverage.
Insurance company name Policy number Company (Area code) Telephone number
Vehicles – attach copies of the vehicle registrations
Enter the number of driver training cars used by your school: List each car, use additional sheets, if necessary.
YearMakeModelLicense numberLocationDual controls?
Yes No
Yes No
Yes No
Yes No
Affidavit
Any misrepresentation or concealed material facts is sufficient cause for denial or suspension of your license.
Any conduct resulting in violation of the laws governing driver training schools or instructors is just cause for revocation
or suspension of your license or other sanctions.
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.
PRINT or TYPE Name of owner, partner, associate, or corporate officer
Date and place signed Signature
PRINT or TYPE Name of owner, partner, associate, or corporate officer
Date and place signed Signature
PRINT or TYPE Name of owner, partner, associate, or corporate officer
Date and place signed Signature
PRINT or TYPE Name of owner, partner, associate, or corporate officer
Date and place signed Signature
RCW 18.235; 46.82; 46.82.325
DTS-661-001 (R/4/16)WA Page 2 of 3
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When you have completed this form, please print it out and sign here.
When you have completed this form, please print it out and sign here.
When you have completed this form, please print it out and sign here.
When you have completed this form, please print it out and sign here.
Curriculum review – Main renewals only
Main renewal applicants must complete this page for each school and branch location. Attach additional copies if needed.
School name License number
Answer the following
Does your school instruct students under 18 years of age? ..................................... Yes No
Curriculum used
Which curriculum?
WRPC AAA ATSEA Custom: Last date approved
Target Zero video
Which session?
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Organ donation
Taught during which session?
Parent night Other
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Taught using which materials?
It’s Your Choice, volume 2 Letter to parents The Heart of Your License flyer
Taught using which method?
Instructor led Video Handouts Guest speaker
Bicycle/ Pedestrian
Taught during which session?
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Other
Taught using which materials?
Share the Road video Driving Safely Among Bicycles quiz Pamphlet/Handout
Motorcycle safety
Taught during which session?
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Other
Taught using which materials?
Motorcycle safety intersection Second Look (DOL video) Cars, Motorcycles, and a Common Road
PRINT or TYPE School representative name
School representative signature
DTS-661-001 (R/4/16)WA Page 3 of 3
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