Pekin – APR. $360 – Open Road Driving School

Class Details

Wednesday, April 15 - Wednesday, April 29

Class Times

Sat. 11:30-2:30pm & 4/10, Sun. 1:30-4:30pm;
Mon. & Wed. 6:15-9:15pm & 4/3

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 # (Not required)

Student Cell Number

Name of School *

Primary Email Address *

Parent Cell Number *

Parent First and Last Name *

Work or Home Number

Primary Doctor *

Primary Doctor Phone Number *

Preferred Hospital

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