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School Bus Clinic Registration
http://bit.ly/icsbc
for responders
https://forms.gle/hg4rkvuoms8PfBGc8
Saturday April 27, 2024 or Dec 2024 TBD
Location
ABC i SEE Driving School
12 Canada Street
Swanton, VT
Across the street from M&T Bank
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* Indicates required question
PARTICIPANT'S NAME AS PRINTED ON DRIVER"S LICENSE
*
(Last name, First name, Middle) PLEASE PRINT YOUR NAME AS IT is spelled ON YOUR DRIVER'S LICENSE
Your answer
Date of Birth
*
Month _______________ Day ___________ Year ________________
MM
/
DD
/
YYYY
Driver License
*
License Number, _____________________________________ State_____________
Your answer
Check one of the following:
New Type I
New Type 2
New Unknown
Renewal Type 1
Renewal Type 2
Renewal Unknown
Row 1
New Type I
New Type 2
New Unknown
Renewal Type 1
Renewal Type 2
Renewal Unknown
Row 1
Mailing Address:
Number and Street , or PO Box ___________________________________________________
Your answer
Town, State, Zip Code
Town, State, Zip _____________________________________________________________
Your answer
Home Phone:
Your answer
Work Phone:
Your answer
Email Address:
Your answer
Clinic Date
April 27, 2024
December 2024 TBD
Other:
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Clinic Location
Swanton
12 Canada Street (ABC i SEE Driving School)
Other:
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Clinic Instructor
Irene Cook
Irene Cook
Option 2
Other:
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Your Question or Comment
Your answer
Did you get your license with a waiver for the clinic?
Yes
No, did not get license or renewal yet
Other:
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