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Student Information

Legal First Name *		Legal Middle Name		Legal Last Name *

Nickname / Preferred Name

Email Address *

Home Phone *		Cell Phone

Birth Date (mm/dd/yyyy) *
	/		/

Sex *

Permit Information

Number
Issuance Date
Expiration Date

Primary Address

Address *

City *		State *		Zip *

Secondary Address

Address *

City *		State *		Zip *

Parent (Guardian) #1 (Optional)

First and Last Name *		Email Address

Home Phone *		Work Phone *		Work Extension

Cell Phone *

Parent (Guardian) #2 (Optional)

First and Last Name		Email Address

Home Phone *		Work Phone *		Work Extension

Cell Phone *

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Account Information

Username *

Password *

Confirm Password *

Password policy: 8 character minimum, having any combination of alphabetic, numeric, and symbolic characters.

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Behind the Wheel Instruction

There are currently no courses available for registration for this service.

2020 - Driving appointments

Classroom Instruction

There are currently no courses available for registration for this service.

2020 - Session # 042020
April 20 - April 24
Class runs April 20 - 24, M-F, from 9:00a.m. - 3:30p.m. at our Shrewsbury classroom. Students are responsible for their own transportation to and from class.

Parent Orientation

There are currently no courses available for registration for this service.

2020 - Parent Class #041720
April 17
Parent Class Friday, April 17th, 6:30p.m. - 8:30p.m. at our Shrewsbury classroom. The $10.00 fee is paid at the door. Please call the office and leave a message stating you want to attend. You will only get a call back if the class is full.

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Register a New Student

Student Information

Permit Information

Primary Address

Secondary Address

Parent (Guardian) #1 (Optional)

Parent (Guardian) #2 (Optional)

Account Information

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