Education Resource of Texas Pre-Registration Form


Education Resource of Texas 1110 W. William Cannon Drive · Austin Texas

DWI, DOEP, Theft & Anger Management Classes · Suite 302 For classes listed above call: 512-786-3673 DWI Intervention Class · Suite 301 For DWI Intervention Class call: 512-786-3673

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Pre-Registration Form for

DOEP Drug Offender Education Program Course

Pre-Registration allows us to better anticipate class size and to notify you in the
unlikely event of changes to the class schedule.

Required fields are marked with an asterisk.

*Your Name:

*Address:

*City:

*State:

*Zip:

*Daytime Phone:

*Evening Phone:

*Email Address:

Question/Comment:
(if any)

DOEP Class Schedules — Austin Texas
The DOEP Course is comprised of FIVE 3-hour classes; fee is $100.00:
Advance payment (in person or by PayPal) is required.
Please select the Class Schedule that you'd like to attend from the list below:

	Monday Jul 16, '18 6 pm to 9 pm	&	Tuesday Jul 17, '18 6 pm to 9 pm	&	Wednesday Jul 18, '18 6 pm to 9 pm	&	Thursday Jul 19, '18 6 pm to 9 pm	&	Friday Jul 20, '18 6 pm to 9 pm

	Monday Jul 23, '18 10 am to 1 pm	&	Tuesday Jul 24, '18 10 am to 1 pm	&	Wednesday Jul 25, '18 10 am to 1 pm	&	Thursday Jul 26, '18 10 am to 1 pm	&	Friday Jul 27, '18 10 am to 1 pm

I have read, understand, and agree to abide by the Class Policies as stated HERE.