Action Driving School Registration Form

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Use this form to register for Behind-the-Wheel (Barnesville)

Student (first, middle, last) name *

Student's birthdate *

YYYY

Student phone # *

Mailing address *

Email address (*gmail please) *

For your Driver Education classroom, who was your instructor (or name of driving school)? *

Parent / Guardian name *

Parent / Guardian Phone # *

Parent email address *

Payments:

We accept the following forms of payment:

Pay by check: $350 payable to Action Driving School, LLC.

Pay via Venmo: @actiondriving $356 (includes process and handling fee)

Submit

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