Registration Form
Step 1 of 3: Submit
Driver's Education - ONLINE Class
Student Information
Student First Name
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Student Last Name
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Date of Birth
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Student Email
Parent/Guardian Information
Parent/Guardian Full Name
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Parent/Guardian Email
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Parent/Guardian Phone Number
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Address
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City
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Zip Code
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Select Your Driving Class Date
Online Class - Duke Street
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January 18 - 29, 2021 (M-F 4:00pm - 7:00pm)
January 25 - February 9, 2021 (M-Th 5:30pm - 8:30pm)
February 15 - March 2, 2021 (M-Th 5:30pm - 8:30pm)
March 8 - 23, 2021 (M-Th 5:30pm - 8:30pm)
March 15 - 26, 2021 (M-F 4:00pm - 7:00pm)
Payment Options
Payment Options (You must choose one)
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Pay Deposit and mail payment to: PO BOX 3502 Prince Fred. 20678 ($25 USD)
Pay Deposit and receive invoice ($25.00 USD)
Pay in Full ($315 USD)
Question? Contact Us
Office@chesapeakeDS.com
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I have been provided a copy of CDS policy and procedure.
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Date:
Tuesday, 19 January 2021 (EST)
Name:
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