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 ... use 'FREE' for free online course)

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 -- Google Yahoo Bing Friend School Flyer Other

Other

High School

- none assigned - AB Miller Adult Alta Loma High School Alternative Education Center Arlington High School Ayala High School Biola Highschool Bishop Amat Bloomington Hs Bonita High School Boys Republic Brea Olinda High School Buena Vista By His Grace Christian Academy Cal-Poly Pomona Calvary Baptist High School Calvary Chapel High School Canyon High Carter High School CAVA Centennial Highschool Chaffey College Chaffey High Charter Oaks Chico State Chino High School Chino Hills High School Christian Heritage Citrus Valley High School City of Knowledge Claremont High School Colony High School Colton High School Corona High School Crossroads Christian School Cvla Damien High School Diamond Bar High School Diamond Ranch High School Don Antonio Lugo High School Edwards Academy Eisenhower High School El Dorado High School Eleanore Roosvelt Encore High School For The Arts Escondido Adventist Academy Esperanza High School Etiwanda High School Flabob High School Fullerton College Fullerton Highschool Ganesha High School Garey High School Glendora High School Hacienda Heights Halstrom Academy Hill Crest High School Home Schooling Hybrid Innovative Technologies I-Poly Independent Study Insight School of California John F Kennedy Highschool John North High School Jurupa Hills Highschool Jurupa Valley Hs Kaiser High School La Habra High School La Puente High School La Salle La Serna Lavern Lutheran High School Lb Polytechnic Lee V Pollard Los Altos Los Osos High School Mark Keppel High School Martin Luther King High School Mater Dei H.S. Matter Dei High School Milor High School Montclair High School Moreno Valley Hs Mount Sac Nogales High School Norco College Norco Highschool Norte Vista High School Northview High School Notre Dame High School Online Student Ontario Christian High School Ontario High School Options for Youth Orange County High School of the Arts Orange Lutheran Pacific Coast High Pacifica Christian High Palo Verde High School Park West Hs Patriot High School Poly High School Pomona Catholic High Pomona High School Pomona School of Arts Raincross Ramona Convert Ramona High School Rancho Cucamonga High School Rancho Verde High School Rialto High School Rim of The World Riverside Community College Roosvelt High School Rosary High School Roswell High School Rowland Heights Rubidoux Hs San Dimas High School Santa Fe High Santee High School Santiago High School School of Arts & Enterprise Serrano High School Sherman Oaks High School Sky Mountain Charter High School Sonora High School South Hills High School Southland Christian St Michaels Preparatory St Paul High School St. Lucy's Summit High School Survite High Temescal Cyn High The Webb School of California Troy High School Ucr Upland Christian Academy Upland High School Valencia High School Valley View High School Village Academy Walnut High School Webb School West Covina Western Christian ISP Western Christians Wilson High School Woodcrest Christian Yorbalinda Yucaipa Zupanic High School

Additional Comments

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