{"id":18352,"date":"2024-03-07T05:48:06","date_gmt":"2024-03-07T05:48:06","guid":{"rendered":"https:\/\/www.northwesterndriving.com\/?page_id=18352"},"modified":"2024-03-07T05:48:09","modified_gmt":"2024-03-07T05:48:09","slug":"road-test-registration","status":"publish","type":"page","link":"https:\/\/www.northwesterndriving.com\/?page_id=18352","title":{"rendered":"Road Test Registration"},"content":{"rendered":"<div id=\"erf_form_container_3136\" class=\"erf-container erf-contact erf-label-top erf-layout-one-column erf-style-rounded-corner\">\n        \n    \n         \n                    <div class=\"erf-content-above\">\n                Contact us by filling out the form below.            <\/div>\n            <form method=\"post\" enctype=\"multipart\/form-data\" class=\"erf-form erf-front-form\" data-parsley-validate=\"\" novalidate=\"true\" data-erf-submission-id=\"0\" data-erf-form-id=\"3136\">\n                <div class=\"erf-form-html\" id=\"erf_form_3136\">\n                    <div class=\"rendered-form\">\n                        <div class=\"erf-checkbox-group form-group field-field-IOr6ReXXGVDG47m erf-element-width-12\"><label for=\"field-IOr6ReXXGVDG47m\" class=\"erf-checkbox-group-label\">Please select a date you would like to take your road test.<span class=\"erf-required\">*<\/span><\/label><div class=\"checkbox-group\"><div class=\"checkbox\"><input id=\"field-IOr6ReXXGVDG47m-0\" name='field-IOr6ReXXGVDG47m[]' required='required' class='form-control' multiple='1' data-ref-label='Please_select_a_date_you_would_like_to_t'  type=\"checkbox\" value=\"&quot;Custom Date&quot;\" \/><label for=\"field-IOr6ReXXGVDG47m-0\">Select this box if you would like to arrange to take the road test at the soonest available date<\/label><\/div><\/div><\/div><div class=\"erf-checkbox-group form-group field-field-ZWxbJLCV0md5Akc erf-element-width-12\"><label for=\"field-ZWxbJLCV0md5Akc\" class=\"erf-checkbox-group-label\">Please select which service you need<span class=\"erf-required\">*<\/span><\/label><div class=\"checkbox-group\"><div class=\"checkbox\"><input id=\"field-ZWxbJLCV0md5Akc-0\" name='field-ZWxbJLCV0md5Akc[]' data-ref-label='Please select which service you need' required='required' class='form-control' multiple='1'  type=\"checkbox\" value=\"Road Test $100\" \/><label for=\"field-ZWxbJLCV0md5Akc-0\">Road Test $100<\/label><\/div><\/div><\/div><div class=\"erf-text form-group field-field-71LxRd4HnkMJ0SR erf-element-width-12\"><label for=\"field-71LxRd4HnkMJ0SR\" class=\"erf-text-label\">Parent\/Guardian Name<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-71LxRd4HnkMJ0SR' required='required' data-ref-label='ParentGuardian_Name' id='field-71LxRd4HnkMJ0SR'  \/><\/div><div class=\"erf-text form-group field-text-231293920791 erf-element-width-12\"><label for=\"text-231293920791\" class=\"erf-text-label\">First Name<span class=\"erf-required\">*<\/span><\/label><input type='text' maxlength='50' required='required' class='form-control' name='text-231293920791' data-ref-label='First_Name' id='text-231293920791'  \/><\/div><div class=\"erf-text form-group field-field-hRuOnl8b1YAL6yj erf-element-width-12\"><label for=\"field-hRuOnl8b1YAL6yj\" class=\"erf-text-label\">Middle Name<span class=\"erf-required\">*<\/span><span class=\"tooltip-element\" tooltip=\"If no middle name, please enter &quot;NONE&quot;\"><i class=\"fa fa-info\" aria-hidden=\"true\"><\/i><\/span><\/label><input type='text' maxlength='50' required='required' class='form-control' name='field-hRuOnl8b1YAL6yj' data-ref-label='Middle Name' id='field-hRuOnl8b1YAL6yj'  \/><\/div><div class=\"erf-text form-group field-text-149821507544 erf-element-width-12\"><label for=\"text-149821507544\" class=\"erf-text-label\">Last Name<span class=\"erf-required\">*<\/span><\/label><input type='text' required='required' maxlength='50' class='form-control' name='text-149821507544' data-ref-label='Last_Name' id='text-149821507544'  \/><\/div><div class=\"erf-text form-group field-field-AfxdDagB0mfmPDU erf-element-width-12\"><label for=\"field-AfxdDagB0mfmPDU\" class=\"erf-text-label\">DATE OF BIRTH (MM\/DD\/YYYY)<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-AfxdDagB0mfmPDU' required='required' data-ref-label='DATE_OF_BIRTH_MMDDYYYY' id='field-AfxdDagB0mfmPDU'  \/><\/div><div class=\"erf-text form-group field-field-i4DtoFUa1AXve49 erf-element-width-12\"><label for=\"field-i4DtoFUa1AXve49\" class=\"erf-text-label\">Phone Number (Guardian\/Parent)<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-i4DtoFUa1AXve49' required='required' data-ref-label='Phone_Number_GuardianParent' id='field-i4DtoFUa1AXve49'  \/><\/div><div class=\"erf-text form-group field-field-rWchxFdcta2RSYR erf-element-width-12\"><label for=\"field-rWchxFdcta2RSYR\" class=\"erf-text-label\">Phone Number (Student)<\/label><input type='text' class='form-control' name='field-rWchxFdcta2RSYR' data-ref-label='Phone_Number_Student' id='field-rWchxFdcta2RSYR'  \/><\/div><div class=\"erf-text form-group field-field-eaxggBuNWlDNtE8 erf-element-width-12\"><label for=\"field-eaxggBuNWlDNtE8\" class=\"erf-text-label\">Instruction Permit #<span class=\"erf-required\">*<\/span><\/label><input type='text' class='form-control' name='field-eaxggBuNWlDNtE8' required='required' data-ref-label='Instruction_Permit_' id='field-eaxggBuNWlDNtE8'  \/><\/div><div class=\"erf-text form-group field-field-8famFgu6IWU1dnm erf-element-width-12\"><label for=\"field-8famFgu6IWU1dnm\" class=\"erf-text-label\">Instruction Permit - Date of Issue:<\/label><input type='text' class='form-control' name='field-8famFgu6IWU1dnm' data-ref-label='Instruction_Permit__Date_of_Issue' id='field-8famFgu6IWU1dnm'  \/><\/div><div class=\"erf-text form-group field-field-3eFG9cKJGEOFBAK erf-element-width-12\"><label for=\"field-3eFG9cKJGEOFBAK\" class=\"erf-text-label\">Did you complete Driver's ED with Northwestern Driving School? If not, please state where.<\/label><input type='text' class='form-control' name='field-3eFG9cKJGEOFBAK' data-ref-label='Did_you_complete_Drivers_ED_with_Northwe' id='field-3eFG9cKJGEOFBAK'  \/><\/div><div class=\"erf-email form-group field-text-28041159624 erf-element-width-12\"><label for=\"text-28041159624\" class=\"erf-email-label\">Email<span class=\"erf-required\">*<\/span><\/label><input type='email' required='required' class='form-control' name='text-28041159624' data-ref-label='Email' id='text-28041159624'  \/><\/div><div class=\"erf-textarea form-group field-textarea-22918989679 erf-element-width-12\"><label for=\"textarea-22918989679\" class=\"erf-textarea-label\">Questions\/Comments?<\/label><textarea maxlength='500' rows='5' class='form-control' name='textarea-22918989679' data-ref-label='QuestionsComments' id='textarea-22918989679' ><\/textarea><\/div><div class=\"erf-button form-group field-button-20889816582 erf-element-width-12\"><button type='submit'class='btn btn-default'name='button-20889816582'data-ref-label='Send'id='button-20889816582'>Send<\/button><\/div>                    <\/div> \n                <\/div>    \n\n                <div class=\"erf-external-form-elements\">\n                    \n                    \n                    \n\n                    \n                                        <div class=\"erf-errors\" style=\"display:none\">\n                        <span class=\"erf-errors-head erf-error-row\">Error occured. Please confirm your data and submit again:<\/span>\n                        <div class=\"erf-errors-body\">\n                                                    <\/div> \n                    <\/div>\n\n                <\/div>\n                <!-- Contains multipage Next,Previous buttons -->\n                <div class=\"erf-form-nav clearfix\"><\/div> \n\n                <!-- Single page form button -->\n                <div class=\"erf-submit-button clearfix\"><\/div>\n\n\n                <input type=\"hidden\" name=\"erform_id\" value=\"3136\" \/>\n                <input type=\"hidden\" id=\"erform_submission_nonce\" name=\"erform_submission_nonce\" value=\"960173de5f\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F18352\" \/>                <input type=\"hidden\" name=\"action\" value=\"erf_submit_form\" \/>\n\n            <\/form>\n            \n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"elegant_blocks_team_1":false,"elegant_blocks_blog_1":false,"elegant_blocks_slider_1":false,"1536x1536":false,"2048x2048":false,"bizberg_medium":false,"bizberg_gallery":false,"bizberg_blog_list":false,"bizberg_detail_image":false,"bizberg_detail_image_no_sidebar":false,"bizberg_portfolio_homepage":false,"bizberg_blog_list_no_sidebar_1":false},"uagb_author_info":{"display_name":"admin","author_link":"https:\/\/www.northwesterndriving.com\/?author=1"},"uagb_comment_info":0,"uagb_excerpt":null,"_links":{"self":[{"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=\/wp\/v2\/pages\/18352"}],"collection":[{"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=18352"}],"version-history":[{"count":1,"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=\/wp\/v2\/pages\/18352\/revisions"}],"predecessor-version":[{"id":18353,"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=\/wp\/v2\/pages\/18352\/revisions\/18353"}],"wp:attachment":[{"href":"https:\/\/www.northwesterndriving.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=18352"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}