ARIN IU28.org

ARIN IU28 Driver Education Program

Please complete the following pre-registration eligibility form:

This form is to only be completed by the Parent or Legal Guardian of the potential student.

Program Selection

Choose:

Student Information

School District
First Name:
Last Name:
Jr., Sr., etc.:
Address:
Address:
City:
State:
Zip:
Date of Birth: --
Grade in 2013-2014 School Year
Student's Email Address:

If your student has a learner's permit or license, please complete the following:

Learner's Permit or License:
Permit/License Number:
Expiration Date: --
 

Parent or Legal Guardian Information

First Name:
Last Name:
Jr., Sr., etc.:
Address:
Address:
City:
State:
Zip:
Phone Number:
Cell Phone Number:
Parent's Email Address:
 

Disclaimer: The submission of this form will be used to determine the eligibility of the student to be enrolled in the ARIN Driver Education Program. Submitting this information does not automatically enroll the student in the class. Once the student's eligibility is determined, you will receive a confirmation email from ARIN that includes the next step in the registration process and the cost of the course.

Contact
If you have any questions in regard to ARINís Driver Education Program, contact us at

Phone: 724-463-5300 x1239

Email: reg4drved@iu28.org