Driver’s Education Registration:
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Personal Information Student |
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Full name
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Nickname (Name you prefer)
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Home address
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Home phone
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Mobile or cellular phone
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Home e-mail address
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Birthday (MM/DD/YYYY)
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Driver’s license number
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School Currently Attending (Grade)
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Emergency Information |
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In case of emergency, contact (Relationship)
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Emergency contact’s phone
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Alternate Name (Relationship)
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Alternate Number
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