EmailMe Form - AMI - Course Registration

Privacy Policy:

The information you provide on this form will be kept as securely as possible. It will never be sold to a third-party for marketing purposes.

Personal Information

Enter your complete legal first, middle, and last names as they appear on government issued ID. Do NOT use initials.

Complete First Name *

Complete Middle Name *

If you have no middle name, enter "none" in this field.

Legal Last Name *

Suffix

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Must be your legal residence as it appears on your government issued ID.

Date of Birth *

MM / DD / YYYY

Email *

Phone *

### - ### - ####

Please provide a number where you can be reached. Cell phone number is preferred.

Course Selection

Please select the course you would like to attend.

Select Course *

County of Residence *

Reminder: This course will provide the training required by the state of Missouri to apply for a permit. Participants will receive a certificate of completion that must be taken to their county of residence to apply for the permit. Completion of this course does not guarantee a permit.

Course Date *

MM / DD / YYYY

Must coincide with the date of a course on our schedule or a private course set up in advance.

Payment Options *

NOTE: Any cash payments must be arranged in advance with an AMI instructor.

Notes

Registration Policy:

Your seat will not be reserved until your payment has been made. Failure to attend this class after payment has been made will result in an automatic refund of your payment less the $50 non-refundable deposit.

Registration Agreement *

I agree to the Registration Policy

By checking this box, you acknowledge that you are agreeing to the above stated Registration Policy.

Form ID Number