The Right Turn DUI Class Registration Form

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Please enter a valid phone number.

Date of Birth*

Please Enter Your Date of Birth

Driver License #*

Please Enter Your License Number

Driver License State*

Email*

Confirmation Emailexample@example.com

Class*

Assessment & Risk Reduction Class

You MUST select a class location to see available schedule.

Which Location Will You Attend*

In-PersonVirtual via Zoom

IN PERSON CLASS SELECTION (Please note: This course will last for 3 consecutive days from the date selected below.)*

VIRTUAL CLASS SELECTION (Please note: This course will last for 3 consecutive days from the date selected below (unless otherwise noted.)*

Start Date Time of First Class (You MUST ATTEND ALL CLASSES!)

Class Schedule

Saturday: 9am - 6pm&#13;&#10;Sunday: 9am - 6pm&#13;&#10;Monday: 6pm - 10pm&#13;&#10;&#13;&#10;Please note you must attend class for ALL THREE DAYS!

Office Use Only

Total

USDCost of Class

STATEMENTS OF UNDERSTANDING

I understand and agree to the following:

Mandatory 5 student enrollment required to have a class.
This course is an In-Person or Zoom Class
This DUI course will start promptly at 9am and end at 6pm. There will be a 1 hour lunch break from 1pm until 2pm. I understand that if I am late returning from lunch, the instructor has the right to refuse my entry and that no refund will be given.
This DUI Course is a 20 hours course and will take place over 3 consecutive days.
Refund Policy - No Refunds will be given.

I have read and agree to the above Statements of Understanding*

I AgreeI Do Not Agree

Discount

SubTotal

Total After Discount