First Name:
Last Name:
Drivers License #:
Drivers License expiry date:
Email:
Primary Phone #:
Course Time	Select a Preferred Course Time Morning Evening Other
	I hereby certify that the information provided above is accurate and upon the registration date that I enrolled in as indicated above I will have my drivers license or an alternative form of proof of identification when registering for the course in person at IQ Academy of Driving located in 845 Upper James St.,

Please call if a class conflicts with your schedule so we may reschedule to avoid conflicts