Fillable Printable Form MV-279 - Request for Classroom Premises Check - New York

Form MV-279 - Request for Classroom Premises Check - New York

www.dmv.ny.gov

CLASSROOM AND EQUIPMENT REQUIREMENTS

Classroom facilities must:

l be 200 square feet or larger. Smaller classrooms will not be approved.

l be clean, comfortable (conducive to learning), and easily accessible to students with disabilities.

l provide adequate seating for each student. Classroom space must allow 20 square feet for each student. Capacity will

be calculated on the basis of 200 square feet for the first ten or fewer students, and 20 square feet for each additional

student, with no more than 36 students in any class.

l have adequate heating and ventilation.

l have adequate lighting.

l have shades or the ability to darken the room when audiovisual equipment is being used.

l have rest room facilities easily accessible to students.

l be free from any visible and audible distractions.

l include the following equipment:

- chalkboard or flipchart(s): minimum size for a ten-student classroom is 2 feet x 3 feet; a larger board or chart

may be required for a larger capacity room. All students must be able to see the board or chart without difficulty.

- audiovisual equipment: must be suitable for presenting materials appropriate to the Prelicensing Course.

REQUEST FOR CLASSROOM PREMISES CHECK

FOR PRELICENSING COURSE

All classrooms that are used for the Prelicensing Course must be approved by the Department of Motor Vehicles. As stipulated in Part

7 (see form CR-7) and Part 76 (see form CR-76) of the Commissioner’s Regulations, no Prelicensing Course may be conducted unless

the classroom has been approved and a qualified instructor is present. To request classroom approval, you must complete page 1 of this

form for each classroom location, and send it to the department to arrange for a premises check (for each location). Part 7 and Part 76

of the Commissioner’s Regulations establish requirements for the Prelicensing Course. The classroom requirements are found

specifically in Sections 7.6 and 76.2(f). Complete ONLY page 1 of this form and mail it to the address at the bottom of this page.

MV-279 (8/15)

PAGE 1 OF 2

Mail to: NYS Department of Motor Vehicles

Bureau of Driver Training Programs

6 Empire State Plaza

Room 412

Albany NY 12228

INSTRUCTIONS: Write in this section only. Do not write on the back of this form. After you have completed this

section, mail this form to the address below.

School/Organization _________________________________________ Owner ____________________________________

Main Office Address __________________________________________________________________________________

____________________________________________________________________________________________________

(City) (State) (Zip Code)

Telephone Number _____________________________ School License Number ____________________________________

Classroom Address

(if different from above) ________________________________________________________________________________

____________________________________________________________________________________________________

(City) (State) (Zip Code)

(Number and Street)

A. CLASSROOM

Does the classroom adequately comply with the following criteria?

Yes No

1. Accessible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . oo

2. Minimum size - 200 square feet. . . . . . . . . . . . . . . oo

3. Clean . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . oo

4. Accessible Toilet Facilities. . . . . . . . . . . . . . . . . . . oo

5. Well-heated/ventilated . . . . . . . . . . . . . . . . . . . . . . oo

Yes No

6. Well-lit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . oo

7. Good line of vision from all seats . . . . . . . . . . . . . oo

8. No visual or audible distractions . . . . . . . . . . . . . . oo

9. Room can be darkened for best

viewing of visual aids. . . . . . . . . . . . . . . . . . . . . . . oo

School or Organization

Classroom Address

(Include Building Name & Room Number)

(Zip Code)(State)(City)

B. EQUIPMENT Yes No

1. o Chalkboard or o Flipcharts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . oo

2. TV/VCR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . oo

3. Other ____________________________________ __________________________________________________________

___________________________________________________________________________________________________ oo

C. Classroom Size (sq. ft.) _____________ Number of Students Permitted in Classroom ______________

(allow 20 sq. ft. for each student with a maximum of 36 students)

D. Number of Pre-licensing Courses offered weekly: ________________

E. Projected 2-month supply of MV-278 books: _________________

(Multiply number of classes per week by maximum number of students per class. Multiply this number by 8 and divide total by 50)

F. Remarks: ____________________________________________________________________________________________________

_____________________________________________________________________________________________________________

Person Interviewed (Name and Title) __________________________________________________________________________________

Examiner’s Signature ____________________________________Shield Number __________________________ Date ______________

INSPECTOR’S CHECK LIST:

NOTE: If premises are disapproved, school owner must reapply when ready for another inspection.

RECOMMENDATION: o APPROVED o DISAPPROVED

P.M.V.L.E.’s Signature ç______________________________________________________________________________________________

INITIAL INSPECTION

MV-279 (8/15)

NOTE: This page to be completed only by DMV Personnel!

PREMISES CHECK REPORT

Date

(Please send to the Bureau of Driver Training Programs)

PAGE 2 OF 2

Person Interviewed (Name and Title) __________________________________________________________________________________

Examiner’s Signature ____________________________________Shield Number __________________________ Date ______________

FOLLOW-UP INSPECTION

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