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Alive at 25 Class Schedule/Standard Registration Form

(Standard registration not available to those who are court-referred.)
Court-Referred Registration Form

All registrations through South Dakota Safety Council.
Three ways to register:
Mail:
South Dakota Safety Council
1108 N. West Avenue
Sioux Falls, SD 57104
Fax: 605-361-2156 Phone: 605-361-7785/800-952-5539

Choose class location and date:

School of Mines
Classroom Building Room 107
Address: 510 East St. Joseph Street, Rapid City, SD

All classes held from 12:30 p.m. – 5:00 p.m
December 9, 2017 ______
January 27, 2018 ______
March 17, 2018 ______


Last name:_______________________________ First name: ____________________________

Middle Initial:_______________ Date of Birth:______________________

Address: ______________________________________________________________________

City, State, Zip: _________________________________________________________________

Phone: _________________ Drivers License Number:___________________________________

Tuition: Due one week before class. $65 + tax payable to the South Dakota Safety Council, 1108 N. West Ave/Sioux Falls, SD 57104 (checks, money orders, and credit cards accepted).

_____ Payment enclosed: _____ Check _____ Money order
Credit card payment: _____ Visa _____ MasterCard _____ American Express

Card Number: __________________________ Exp. Date _____/_____

Name on Card:_________________________________________


Contact the South Dakota Safety Council at sdsc@southdakotasafetycouncil.org
or phone 605-361-7785 or 1-800-952-5539.