Defensive Driving and Maltreatment Awareness Training

Primary Contact Information. Please provide contact information for the manager or administrative support person who is coordinating this registration.

* Required field

Agency*

Primary Contact Name*

Primary Contact E-mail*

Phone*

Emergency Phone Number - will be used in case of class cancellation

Street Address*

City*

Zip Code*

Please select a date and location

Saturday, April 21st
8 a.m. to 4:30 p.m.
Guardian Angels of Elk River





Saturday, April 28th
8 a.m. to 4:30 p.m.
Wadena County Human Services

Saturday, May 19th
8 a.m. to 4:30 p.m.
Greater Mankato Transit System

Please tell us the names of the drivers who will be attending this class on this date. You may register up to five drivers at one time. If you are registering for more than one date, please complete additional forms.

Name*

Name

Name

Name

Name

Expense Estimate for this Class

Please provide estimated expenses for this class. Keep all receipts, after the class you will need to fill out an expense reimbursement form and mail it along with your receipts to the office of Transit. Please see guidelines for more detail about expense reimbursement. Reimbursements will be sent to your organization, not to the individual drivers.

Mileage

Please carpool when possible. Calculate roundtrip mileage at .555 cents per mile, or your agency rate, whichever is less.

Number of miles roundtrip

Meals
Meals that are not provided as part of the training program

Breakfast total

Lunch total

Dinner total

Lodging

Total number of nights x daily hotel rate per student

Total estimated expenses

Total expenses

Comments

Is there anything else about your registration that you would like us to know?