PRNDL Driver Education LLC
Registration
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Email *
Student First Name *
Student Last Name *
High School the student attends? *
Student Phone Number  *
Parent/Guardian - First and Last Name 
 *
Parent/Guardian - Phone Number
 *
Parent/Guardian - Email
 *
Address *
Learners Permit Number *
Permit Issue Date *
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YYYY
Permit Expiration Date *
MM
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DD
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YYYY
Date of Birth *
MM
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DD
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YYYY
Does your student have any physical or learning disabilities that may affect their ability to learn in the classroom or behind the wheel?  The information is important to the instructor to help accommodate student. *
Please confirm your students availability on the posted dates, your student will have a drive partner that depends on their attendance. All classes and drives must be attended due to ODOT program requirements. There will be a $40 fee - less than 24 hour notice or NO SHOW on scheduled drive. No issuance of any certificate will be allowed until fee is paid. *
Required
Please tell us how you found out about PRNDL.  *

Student preferred drive day and time. Choose 1-3 options for flexibility to help with scheduling.

Morning drives available-flexible

Wed 1:30-3:30 OR 3:30-5:30
Thu 2:30-4:30 OR 4:30-6:30
Fri 2:30-4:30 
 *
Check box to Pay - Payment in FULL required to reserve drive date and class space.  ** After Registration allow 3-4 business days for verification and conformation email.**
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