Enroll a New Student - Step 1: Your Personal Information

Thank you for choosing to enroll in our school. In just a few minutes, you will be able to start your online driving course. The enrollment process is quick and easy:

Step 1 - First we need some information about you. The items marked with an asterisk (*) are required to enroll. The other items are optional, but may be needed later depending on what courses you take.
Step 2 - You will be given a choice of courses to enroll in, along with the final costs associated with each option. You will also choose a password so you can securely log into our Students-Only section.
Step 3 - Sign-in with your new password, pay your bill online (using PayPal), and begin your online drivers education course. If you have also selected the Behind-the-Wheel Training option, you may pay all or just make a small deposit.

We look forward to serving you!

School Code

(if you were given a code, enter it here)

Student Information

Username (eMail) *

Last Name *

First Name *

Middle Name

Date of Birth *

Gender

Male Female

Parent (or person responsible for payment)

Last Name

First Name

Middle Name

Home Address

Address

City *

State

Zip Code *

Contact Information

Home Phone *

Cell Phone *

Emergency Phone

Emergency Contact

Pick-up Address (if different)

Address

City

State

Zip Code

Driver Details

License/Permit No.

Date Issued

Date Expired

Other Information

Source/Referral

-- none -- Other

Other

High School

- none assigned -

Additional Comments

Submit Information

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