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COURSE
REGISTRATION FORM
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*To register, please print this form, fill and mail it with deposit to: |
(Please print)
Sex (CIRCLE ONE): Male / Female Address____________________________________________________________ City__________________________
Postal Code ______________________________
Home Phone #___________________ Work Phone # ___________________________ Drivers License #_____________________________ Date of Issue ___/___/___ (yy/mm/dd) Course Date: ___/___/___ ___/___/___ ___/___/___ ___/___/___ (yy/mm/dd) Please Note: Should the student have to leave the program, a charge of $40.00 per hour of driving time used will be deducted from the course fee, and an additional $10 will be deducted for every hour of in-class training. You have 1 year to complete the full course. * Fifty ($50.00) dollars deposit must accompany your registration form. This amount will be deducted from the total cost of the course. |