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.