Registration Form and Schedule

To register, print and mail this form with your payment. If you have additonal questions, call 206-243-3564.

All classes are 8 a.m. - 5 p.m. unless noted otherwise.

Date		City	Location
December 2009
	Dec 5 (Sat)	Tacoma	The Villas at Union Park
	Dec 8 (Tue)	Redmond	Redmond Senior Center
	Dec 12 (Sat)	Renton	Highlands Community Church
January 2010
	Jan 16 (Sat)	Renton	Highlands Community Church
	Jan 22 (Fri)	Vancouver	Beautiful Savior Lutheran Church
	Jan 28 (Thu)	Bellevue	First United Methodist Church
	Jan 30 (Sat)	Tacoma	The Villas at Union Park
February 2010
	Feb 6 (Sat)	Seattle (Roosevelt)	Calvary Christian Assembly
	Feb 13 (Sat)	Renton	Highlands Community Church
	Feb 25 (Thu)	Des Moines	Judson Park Retirement Community
March 2010
	Mar 6 (Sat)	Chehalis	Woodland Estates Retirement Community
	Mar 12 (Fri)	Seattle (Ballard)	The Vine Baptist Church
	Mar 13 (Sat)	Renton	Highlands Community Church
	Mar 20 (Sat)	Bremerton	Westside Improvement Club
	Mar 23 (Tue)	Bellingham	Christ the King Community Church
	Mar 25 (Thu)	Sequim	Pioneer Park Clubhouse
	Mar 27 (Sat)	Everett	Sons of Norway / Normanna Hall
	Mar 30 (Tue)	Redmond	Redmond Senior Center
April 2010
	Apr 10 (Sat)	Tacoma	The Villas at Union Park
	Apr 17 (Sat)	Renton	Highlands Community Church
	Apr 24 (Sat)	West Seattle	W. Seattle Christian Church

Registration Information

I/we wish to attend the AAA Driver Improvement Program course as noted above.

Name______________________________________

Address____________________________________

City____________________State____ Zip_______

Day Phone_____________Amount Enclosed $______

AAA Membership #__________________________

E-mail Address (optional)_______________________

Cost

• AAA member: $16
• Non-member: $22
• Court ordered or corporate required class: Prices available upon request. Call: 206-243-3564

Payment Information

1. Print this form
2. Make check payable to "American Driving Services"
3. Mail form and check to:

   American Driving Services

   P.O. Box 66681

   Seattle, WA 98166-0681

4. A confirmation letter will be sent to you about two weeks prior to the class.

Refer any questions about the program to Danny or Mary Lilleness 206-243-3564.

Your Personal Protection

• Auto Insurance
• Home/Renters Insurance
• Life Insurance
• Umbrella Coverage
• Boat/Watercraft Insurance
• Retirement
• Long-Term-Care Insurance
• Short-Term Medical Insurance
• Student Health Insurance

Policy Service

Driver Education