Patriot Auto School Class Registration
Please fill out the form below to pre-register for one of our classes.
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Student's First and Last Name *
Student's Email address *
Student Cell Phone *
Parent/Guardian Phone Number *
Parent's Email address *
Street Address *
Town/City *
Date of Birth *
Which class are you interested in taking? *
Payment Options  (30 hours of class, 12 driving lessons, 6 observations) *
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