Home › Graduated Driver Licensing › Segment 1: Capital City Vineyard Church › RegistrationCapital City Vineyard Church Driver Education Training Registration Student Name* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Birthdate* Driver Education Classes at Capital City Vineyard Church*Select…Segment 1 ($325)Segment 2 ($55)Segment 1 & 2 ($380)Segment 1 Course Dates*Select…October 1 – 24, 2018February 11 – March 6, 2019July 8 –25, 2019September 16 – October 9, 2019Segment 2 Course Dates*Important: Students must hold their Level 1 license for at least 90 days and have completed 30 hours of driving, two of which are at night. Do not sign up for both Segment 1 and 2 classes unless they are at least 3 months apart.Select…October 29 – 31, 2018March 11 – 13, 2019July 29 – 31, 2019October 7–9, 2019Total $0.00 Other InformationNote if the student has any medical, physical, learning, or disability condition here.Payment* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name