Online Defensive Driving Course Registration

Name

First Name*

Middle Name

Last Name*

Previous Name

Address

Address*

City*

State*
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa 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 Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip*

County*

Contact Information

Demographic Info

Birth Date*

Citation Information

Citation Date (mm/dd/yy)*

Citation/Complaint Number*

County Citation Issued*

Completion Date*

Drivers License Number*

Issuing State of Drivers License*
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa 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 Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

If you chose to avoid a conviction by taking a Defensive Driving Course, select the best day/time and location for your class?*
Charleston-Weeknights 5:00 p.m. - 9:00 p.m. Effingham-Wednesday 6:00 p.m. - 10:00 p.m. Effingham-Saturday 8:00 a.m. - 12:00 p.m. Effingham-Saturday 1:00 p.m. - 5:00 p.m. Mattoon - Weeknights 5:00 p.m. - 9:00 p.m. Sullivan-Weeknights 5:00 p.m. - 9:00 p.m. Online

Submit

Once you submit your registration form, you will be responsible for the fee associated with the class you chose.

1. There will be a charge of $75.00 once this registration is submitted.
2. It can take up to 24-48 hours to receive email.
3. If you receive from these counties(Coles,Cumberland,Effingham,Marion,Moultrie,Shelby), it will not be processed and will be sent to the courthouse to be processed first.

If you have chosen to participate in the classroom course, you will receive a class confirmation letter in the mail in 5-7 business days. If you have chosen to participate in the online course, you will receive an email confirmation soon. If you are submitting your online course registration form after business hours, you will receive your confirmation email on the next business day.