1 Pre-Registration Questions2 Student Information3 Payment I have traffic violations pending during my enrollment in this course.*YesNoThe court is reducing or dismissing my ticket upon completion of traffic school.*YesNoIs your enrollment in the course in conjunction with any type of plea agreement or a condition of sentencing?*YesNoNote: No demerit points may be deleted from or credited to your demerit record if your enrollment is in conjunction with a plea agreement or was a condition of sentencing, or if there are more than 11 demerits on your driving record.I have completed a traffic safety course for credit within the past 12 month period.*YesNoIf you marked yes above, please list the name, location, dates of enrollment and completion of the traffic schools attended in the last 12 months.Note: You marked the above question as "Yes." If you received credit for a course within the past 12-month period, you may not be eligible for the deletion of demerit points and may not otherwise receive credit for completing a traffic safety course.Number of traffic violations in the past 12 months:* Student InformationName* First Last Username*Password* Enter Password Confirm Password Email* Phone Number*Mailing Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Driver's License Information (required)Driver's License Number*State of Issue*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificDate of Birth* Terms of Acceptance and SignatureI warrant the truthfulness of the information provided in this application. I agree and understand that: No demerit points may be deleted from or credited to my demerit record if my enrollment is in conjunction with a plea agreement or was a condition of sentencing, or if there are more than 11 demerits on my driving record; I will not be eligible for the deletion of demerit points and may not otherwise receive credit for completing a traffic safety course if I received credit for a course within the past 12-month period; I agree with the Terms and Conditions of this website .Signature* I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance Payment Information (required)5 Hour Traffic Safety School Course* Price: $39.99 Course Eligible for students with 2 or fewer violations in the 12 months prior. Drivers who have no more than 11 points on driving record and students who have not already completed the course in the 12 months prior.Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name CommentsThis field is for validation purposes and should be left unchanged.