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Enroll Now: CA Online Course

Student name and birth date must appear on this form as they do on the student's birth certificate.

Account Login Information
You will need a username and password to access the online course. Please choose your login information below:
Choose Username
Choose Password
Confirm Password
Discount Code
Student Information
First Name
Last Name
Phone Number (xxx-xxx-xxxx)
Email Address
Birth Date
Gender  male  female
High School
Does your high school offer driver's education? no yes
How did you hear about us?
Referral Code
Mailing Address
Mailing Address Street
Mailing Address City
Mailing Address State
Mailing Address Zip Code

Billing Information
  billing address is the same as the mailing address
Billing Address Street
Billing Address Zip Code

Parent or guardian certifies that:
  • I have read the terms and conditions of this course.
  • All statements made on this form are correct.

*Note: Once you submit the form your credit card will be charged $69.95 plus $0.00 for the read along option minus any applicable discounts.