Minors in Possession Class Registration

FORM – English

    Required Contact Information

    MIP - Class Registration Form

    Gender: MaleFemaleNonbinary

    Race (check one or more)
    American Indian
    Pacific Islander
    Alaskan Native

    Ethnicity (check one or more)
    Puerto Rican
    Not of Hispanic Origin

    Have you ever or are you currently serving in the military?: YesNo

    Can we contact you by?: Text MessageEmailHome/Cell PhoneMail

    Can we leave a generic message?: YesNo

    Class Type: DUI - $225DUI (Spanish) - $225MIP - $50MIP (Spanish) - $50USU MIP - $35/$15

    The class fee must be paid prior to the class you are scheduled to attend. If you fail to attend the scheduled class, you will be charged $10.00 to reschedule for the next class. You have only 2 opportunities to complete the class without exception. Classes can be paid for at either of the following locations:

    Bear River Health Department |
    Division of Health Promotion |
    655 E. 1300 N | Logan

    Bear Bear River Health Department |
    800 W. 992 S. |
    Brigham City

    Click the SEND button only once. It will take just a moment to process your information. You will receive a confirmation email if your submission was successful.