TSS REGISTRATION

TRAFFIC SURVIVAL SCHOOL ENROLLMENT
Full Name *

First Name Last Name
Case Number *
Example PBJ12345
Email *
Phone Number *

Area Code Phone Number
Choose Your Date *
Please choose your date from the pull-down menu below. All classes start promptly at 8am and continue until 4:30pm. Please arrive at 7:30am for class check in. A half hour lunch break will be provided so you may bring your lunch, or eat at one of the neighboring eateries.

Please bring the following with you:

1. A photo ID (Driver's license, State issued identification card, etc.)

2. The paperwork you received in the mail from ADOT/National Safety Council that lists your Case # or your printed MVR obtained from servicearizona.com

3. Your payment of $140.00 in the form of cash or money order which includes the National Safety Council Fee.

*Payment will be due upon arrival to class. There are no pre-payment or online payment options at this time.
- CANCELLATION POLICY
  
  I HAVE READ AND ANSWERED THE ABOVE QUESTIONS TO THE BEST OF MY ABILITY. I UNDERSTAND THAT THE DEPOSIT OR ANY PAYMENT PLACED IS NON-REFUNDABLE AND NON-TRANSFERRABLE.
Sign your name electronically to agree:
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