Minors in Possession Class Registration FORM – English Required Contact Information MIP - Class Registration Form Gender: Male Female Nonbinary 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 Have you ever or are you currently serving in the military?: Yes No Can we contact you by?: Text Message Email Home/Cell Phone Mail Can we leave a generic message?: Yes No Class Type: DUI - $225 DUI (Spanish) - $225 MIP - $50 MIP (Spanish) - $50 USU 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.