Individual Registration

Please enter information in the form below to process registration for the class Online Course.

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Phillips Driving School, 2361 S. Titanium Pl., Meridian
Eagle
Nampa

Username*

Password*

Retype password*

Student's First Name *

Student's Last Name *

Parent's Email *

Driver's Permit Number *

Enter parent's mobile number: *

Enter student's mobile number: *

What school does student currently attend? *

Coupon

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Credit Card Payment

Credit Card Number*

Expiration Date*

Card (CVV) Code*

First Name

Last Name

Address

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Phone