*ONLINE CLASS NOW!* Mid-Prairie – OCT. $395

Class Details

October 9, 2024 - October 25, 2024

Class Times

*ONLINE CLASS NOW!* (2 Weeks!) Registration now open!
Drive sessions will be after school, evenings, and weekends. Online class portion due Oct. 13th at 1pm. All drives and course completed by Oct. 25th.

Class Location

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Class Registration Form

Spaces

Student First Name *

Student Last Name *

Student Middle Name

Student Preferred Name

Student Date of Birth (MM/DD/YYYY) *

Student Street Address *

City/Town *

State *

Zip Code *

Student DL No./Permit #

Student Cell Number

Name of School *

Primary Email Address *

Parent Cell Number *

Parent First and Last Name *

Parent Email Address *

Work or Home Number

Primary Doctor *

Primary Doctor Phone Number

Preferred Hospital

How Did You Find Us? *

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Total Price

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