1 Premium Driving School Segment 1 Registration Contract
1 Premium Driving School, Inc.
20111 James Couzens, Detroit, MI 48235
Phone: 313-862-4244

Office Hours: Monday - Friday 9:00am – 5:00pm
Drive Time: Must be Scheduled
Department of State Certificate: #P000651
Email *
Class Start Date: *
Student First Name *
Student Middle Name *
Student Last Name *
Student Age *
Student Birthdate: *
MM
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DD
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YYYY
Address *
City *
Zip Code *
Student email address *
Student cell number *
Parent Name (First & Last) *
Parent phone number  (area code) 123 -4567 *
Parent email address *
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