Student Information Fprm

U. S. Coast Guard Boat America Course- Sep 6 2025 - KBYC
Student Information Form

Complete and submit the form carefully for registration of up to 4 students residing at the same address. For adults this should match your driver's license information. This information will be submitted to the State of Florida to request your Florida Boating Education ID Card. All classes are offered at no cost to the student.
Address for all students residing at the same household.

Use a separate form for each household.
Address*

Street Address

Apartment Number

CityState

Zip Code
Primary Telephone Number*

Area CodePhone Number
Primary Student E-mail*
Students

Please provide the Names, Gender, and Date of Birth for all of the students. The names should match what appears on the students driver's license.
First Student Name

First NameMiddle NameLast Name
First Student Birth Date

MonthDayYear
First Student Gender
Second Student Name

First NameMiddle NameLast Name
Second Student Birth Date

MonthDayYear
Second Student Gender
Third Student Name

First NameMiddle NameLast Name
Third Student Birth Date

MonthDayYear
Third Student Gender
Fourth Student Name

First NameMiddle NameLast Name
Fourth Student Birth Date

MonthDayYear
Fourth Student Gender
Should be Empty:

U. S. Coast Guard Boat America Course- Sep 6 2025 - KBYC