Purchase additional test for member student

Looking to have your child tested at our next testing session at your school?

This is where you can have them added to the list at their schools next testing session.

Parent Name*
First Last
BEST Parent Email (A valid email is extremely important for communications which are often time-sensitive. DFCA will never sell your information.)*
Student Name*
First Last
Select School*
Grade*
Student Birthdate*
MM slash DD slash YYYY
Gender*
Homeroom Number (If Known)
Address*
Street Address Address Line 2 City State ZIP Code
Best Phone*
Parent Cell*
Consent: I Consent to the taking of specimens for drug screening as a part of an examination in connection with participation in Drug Free Clubs of America and authorize the release of those results to DFCA and the above named. I understand this test will be performed at the schools next scheduled test date.*
- Yes, I am the Parent of a minor child participating in DFCA and I consent.
Extra Student Drug Test*
Price:
Student drug test at next school testing
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$20.00