County Wide Partners for Safe Teen Driving Presentation

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Please complete this form to register for the County Wide Partners for Safe Teen Driving Presentations. Priority If you are not a Loudoun County Public school student please complete the registration and reach out directly to Ms. Jennifer Larmer for specific instructions. The full log-in details will be emailed out to all confirmed students on the day of the presentation. Each date is limited to 250 participants in total. Each family should log in on the student's LCPS Chromebook, and an adult and student must both be present and visible on camera during the presentation. Note: Please complete the form with your LCPS information if you are an LCPS student. Outside district students please complete with your student information and best contact.

Email *

FINAL DATE (Participants are limited and will receive an email with details the AFTERNOON OF THE EVENT) *

May 25th, 2021 7pm-9pm

I am an: *

LCPS student

Homeschool student

Private school student

Other

Please list the school you currently attend. Please list even if it is not an LCPS school *

Driver Education Teacher's LAST NAME *

Student Name (LAST, FIRST) *

Student ID # *

Attending Parent/Guardian Name *

Attending Parent/Guardian Email Address:

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