Medina Room Option: 2019
Sharing Room - $320.00
Private Room - $450.00
MEDINA LOCATION REGISTRATION FORM:
Court Case Number:
Date Of Birth:
State Professional Services, Inc.
Driver Intervention Program
Medina Location/Date: 2019
**CALL THE OFFICE FOR JULY DATE**
July 11th - 14th, 2019
August 1st - 4th, 2019
September 5th - 8th, 2019
October 3rd - 6th, 2019
November 7th - 10th, 2019
December 5th - 8th, 2019
Driver Intervention Payments & Registration
Mail in a money order (Must be sent a week before your program date)
Pay the night you arrive. (No Personal Checks)
Pay online with a credit card (fee's apply for this option)
Social Security Number
AFTER YOU HIT SUBMIT, YOU WILL SEE A CONFIRMATION PAGE.
IF YOU DO NOT SEE THIS PAGE, PLEASE RE-SUBMIT OR CALL THE OFFICE TO INFORM US. A CONFIRMATION E-MAIL WILL BE SENT WITHIN 72 HOURS.
STATE PROFESSIONAL SERVICES, INC.
DRIVER INTERVENTION PROGRAM
PO Box 813
Medina, OH 44258
Copyright © State Professional Services, Inc. ALL RIGHTS RESERVED.
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