Course Registration All registration information is strictly confidential and is only used for identificationof the students registered on the site.If you encounter a problem when registering or have any questions, please Contact Us. Personal Information Password: Confirm Password: First Name: Middle Name: Last Name: Physical Address:   City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kanas Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennesylvania Rhode Island South Carolina South Dakota Tenasee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming Zip: Home Phone: (111-222-3333)  E-mail Address: Birth Date: (mm/dd/yyyy)  Gender: Male Female Where did you hear about us? Google Yahoo MSN Search Friend State Website Teacher Learn 2 Drive Usa Other     If other: Parent/Legal Guardian Information Name of Parent or Guardian: Parent’s Work Phone Number: Parent’s E-mail: DDS Required Information When your course is completed, Costech will be entering your information into the State of Colorado School Certification Program for the issuing of your Affidavit of Completion. The additional information in this section is required by the DDS in their Certification program registration. Please complete this information as accurately as possible. Public School Student    Private School Student    Home School Student Race: Asian Black Hispanic/Latino Indian Other Refused Unknown White        Eye Color: Black Blue Brown Green Gray Hazel        SSN:   Height: Feet   Inches              Weight: lbs Colorado ID Card # or Learner Permit # or Driver License #   Payment Information Please select your method of payment:      Credit Card      Check or Money Order Please enter the name of the person making the payment. Name: (first/last) Security Questions During the course, you will be asked security questions to confirm your identity. The answers you provide in this section will be what is used to validate your identity. Please complete this information , and remember that your answers are case-sensetive. Questions: Favorite Sport: Motheres Maiden Name: Favorite Color: Favorite Food Favorite Season: Favorite TV Show: Favorite School Subject: Favorite Band or Singer: Favorite Celebrity: Favorite Sports Team: Hobby: