DUI & MIP Seminar Sign up

Which Seminar are you signing up for(Required)

DUI Seminar

MIP Seminar

Choose A Time for Seminar(Required)

What does your court order say?(Required)

Education Course

Chemical Assessment/Evaluation

Choose A Time for Seminar(Required)

Date of Evaluation(Required)

Location of Evaluation(Required)

Date of Evaluation(Required)

Location of Evaluation(Required)

Is the date of your evaluation within 6 months of the seminar(Required)

Yes

Evaluation needs to be within 6 months of Seminar date. Please call (701)478-8440 if you have any questions.

Name(Required)

First Last

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Date of Birth(Required)

Phone(Required)

Date of Birth(Required)

Drivers License #(Required)

Who needs to be notified of your completion

Please include: Name, Address, Phone and/or Fax If you need anything sent to the courts you will need to provide your case number so it can be filed in the correct case. Some courts will not allow us to file without a case number on the letter.

Who needs to be notified of your completion

How can we help you?

Daytime Phone

or After Hours

Talk to a Counselor

WalkIn Clinic Hours