I-Virtual High - Reinstatement

Form for reinstatement for online Driver Education (DE101)
*Is a required field

Please Leave This Window Open While You Complete The Process. Completed in two steps. First, complete this form and next pay the extension fee. You can exension your time by 15 or 30 days.

Step 1

*Student First and Last Name

* DOB: mm/dd/yyyy

*Address, City, Zip
, , CA

* Phone + Area Code

* Cell/Other + Area Code

* High School Student Attends:

* Student e-mail:

* Parent e-mail:

* Parent or Guardian Name

* Parent / Guardian Phone

Please acknowledge that you have read and the following terms and conditions by entering your initials in the box below.
1	It is understood that you have 15 days to complete the course.
2	After you submit this form you will be routed to a page that has additional instructions.
3	When you do communicate you must include your name, course, and state your question.
4	You must make sure that our correspondence to you in not blocked by your server.
You have read 1-4 above and agree by entering your initials here:

Step 2
By signing below you agree to abide by the rules set forth in the course. Please sign by typing in your name. Once you click submit, you will be routed to the tuition page to pay the extension fee.

* Parent Signature

* Student Signature

Submit this form once.

i virtual high

An electronic education