Registration

Alcohol & Drug Intervention (ADI)

2250 N. 1700 w. Layton Bldg. C

Dates Select May 19 & 20 June 9 & 10 July 14 & 15

First Name Last Name



Gender Select Male Female Age Select 18-20 21-24 25-44 45-64 65+ Race Select Hispanic Non-Hispanic Ethnicity Select Alaskan Native American Indian Asian American Black Pacific Islander White

Address Apt # City Select Bountiful Centerville Clearfield Clinton Farmington Fruit Heights Kaysville Layton North Salt Lake South Weber Sunset Syracuse West Bountiful West Point Woods Cross Other

State Zip

Home # Cell #



Email Address

If you would like us to notify the court of registration and completion of course, please fill out the information below.

Court Judge Case #