Register Registration Please use the form below to register for services… Parent or Guardian*Do you have an email address?* Yes NoEmail (We will use this to send you a copy of the registration for class)*Son/Daughter ( If Adult Please Just type Adult )*As it appears on PermitPayment Method* CashPersonal CheckOnlineClass Choice* Written Permit TestIn Class Instruction ( 8 Hours )Behind the Wheel ( 6 Hours )In Class Instruction and Behind the WheelRoad TestIn Class Instruction, Behind the Wheel and Third Party Road TestCopy Of CertificateAdult Class Per Hour (Minimum of 6 Hours)Insurance Discount (Dependent on insurance provider) applies only if you take both Classroom and Behind the Wheel Classes.Class Date Choice* March 19th, 2023April 2nd, 2023April 16th, 2023May 7th, 2023May 21st, 2023June 4th, 2023June 18th, 2023July 2nd, 2023July 16th, 2023August 6th, 2023August 20th, 2023September 3rd, 2023September 17th, 2023October 1st, 2023October 15th, 2023November 5th, 2023November 19th, 2023December 3rd, 2023December 17th, 2023Student Name*As Appears on PermitDate of Birth*Permit or License Number*Issue Date*Student Address*Student Phone Number*Cell Phone NumberIf no cell number is available please put N/A in this field.Vehicle Acknowledgement* I acknowledge and understand that students will be driving a Ford Taurus, Ford Focus, Ford Fiesta or a Toyota Scion that is an automatic and has an instructor brake on the passenger side.Student Signature*By placing your name in this text box you understand that this is your binding signature.Parent/Guardian Signature*By placing your name in this text box you understand that this is your binding signature.CaptchaIf you are human, leave this field blank.