Central Susquehanna Intermediate Unit

PA: Central Susquehanna IU - Driver Education

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Note: A service fee of $2.50 or 2.95% (whichever is greater) will be assessed for card payments. A fee of $2.00 will be assessed to payments made from checking/ savings accounts. The service fee will appear on the next page. If you do not agree to these terms, please click ‘Cancel’ below and make different payment arrangements. VISA, MasterCard and Discover cards accepted.

HIGH SCHOOL STUDENT SECTION

Student Last Name

Student First Name

Student Email (Please do NOT use a school e-mail address)

D.O.B.

Gender

Male Female

Please Do Not Complete The Following Field

PARENT/GUARDIAN SECTION

Parent/Guardian Last Name

Parent/Guardian First Name

Parent Email

Parent Phone #

Parent Phone # Area Code-Parent Phone # Prefix-Parent Phone # Line Number ext Parent Phone # Extension

HIGH SCHOOL SECTION

School District

Other? If your district is not listed please type in name here

Grade Level Completed

COURSE SECTION

Course Name

PAYMENTS TAKE 2-3 DAYS TO PROCESS. DO NOT REGISTER ON KEYS TO DRIVING WEBSITE.

Note: Refunds will be processed less the service fee.

Note: To continue to payment, please click CHECKOUT below. However, if making a payment for another course, click ADD TO CART.