Minors in Possession Class Registration

FORM – English

Required Contact Information



MIP - Class Registration Form







SMS Reminders: Yes No

Gender: Male Female

Race (check one or more)
White
American Indian
Asian
Latino
Black
Pacific Islander
Alaskan Native
Other

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


Class Fee Paid MIP - $50

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.