Chicago Teen 10-23-23

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10-23-23 (6:30pm-8:30pm) | 3415 W PETERSON, CHICAGO, IL 60659

Parent/Guardian Name (First and Last)*

First Name (Student)*

Last Name (Student)*

DATE OF BIRTH (MM/DD/YYYY)*

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Phone # (Parent)*

Email (Student)*

Email (Parent)*

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Additional Discounted Services*

Online Written Permit Practice ($25)

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