Parent Class Completion Letter

Parent Class Date(Required)

Parent Name(Required)

First Last

Name(Required)

First Middle Last

Student Date of Birth(Required)

Address(Required)

Street Address City State ZIP Code

Email(Required)

Enter Email Confirm Email

SECRET WORDS(Required)

Completion Certificate(Required)

Price:

The state requires the certificate to be mailed (NOT emailed). This fee is to cover those costs. If you decide to log the full 50 hour with your student, the completion letter is not needed.

Credit Card(Required)

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Parent Signature(Required)

First Last

I understand that there are no refunds. This completion letter is not needed if I log 50 hours with my student. Any information that is not entered correctly could cause this certificate to be voided.