Center for Continuing Studies - Innovative Leadership for Lifelong Learning

DIP registration

Driver Improvement Program Registration

* = Required Information
Please fill in your name as you want it to appear on your certificate.

*Location:
Course No.:
*First Name 1:
Middle Initial 1:
*Last Name 1:
E-Mail 1:
*Date of Birth #1:
(MM/DD/YYYY)
*Street Address:
*City:
*State:
*Zip Code:
*Phone: (with Area Code)
(xxx)xxx-xxxx
4 Hr Refresher Course
8 Hr First Time Course

To register another person, please fill out the fields below.

First Name 2:
Middle Initial 2:
Last Name 2:
E-Mail 2:
Date of Birth #2:
(MM/DD/YYYY)
4 Hr Refresher Course
8 Hr First Time Course

Contact MHSRC: mhsc@stcloudstate.edu 320.255.2185 or 1.888.234.1294

Center for Continuing Studies

Contact Information
Phone: (320) 308-3081

Quick links:

St. Cloud State University is an affirmative action/equal opportunity educator and employer.
St. Cloud State University is a member of the Minnesota State Colleges and Universities system.
© 2012 St. Cloud State University