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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: 4 character minimum, having any combination of alphabetic, numeric, and symbolic characters.

Select a School or Location

Adult Drives

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

2020 - Adult Private Lesson

Behind the Wheel Instruction

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

2020 - Indianapolis/71st Drive Times

2020 - CCHS Drive Times

2020 - Cascade Drive Times

Student Drive or Road Test Prep

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

2020 - Student Drive or Road Test Prep.

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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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