CDIC Registration Form

1
Attendees Name* This field is required.
First Name
Middle Name
Last Name
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Attendees Information* This field is required.Please carefully fill in the details below.
Please enter your phone
Please enter your email
Phone Call
Email
Text
Choose your preferred method of contact
Zip code
Driver’s License Number
Date of Birth
3
Photo Identification* This field is required.Upload a clear copy of your DMV-issued Driver's License, Learner's Permit or ID. Note: If you have not obtained a form of identification or it has been removed by the court or DMV, please upload a copy of the DMV paperwork provided and share a photo ID with instructor for identification.
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Max. file size: 10.6MB
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Do any of the below statements apply to you (as listed on 'Executive Order Fifty-Five 2020')?* This field is required.a. visited China, Iran, South Korea, any European countries, or any other high-risk countries identified by the CDC in the previous 14 days; b. traveled domestically within the United States where COVID-19 has sustained widespread community transmission; c. been asked to quarantine, isolate, or self-monitor by any doctor, hospital, or health agency; d. been diagnosed with, or have had contact with anyone who has been diagnosed with, COVID-19; e. a fever, cough, or shortness of breath; or f. resided with or been in close contact with any person in the above-mentioned categories.
YESNO
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Reason for Attendance* This field is required.Please select the course that is applicable to your reason for attendance.
Please Select
Please Select
Court-Appointed for Dismissal or Reduction
DMV Ordered (By Mail or In-Person [Compliance Summary])
Volunteer for Positive Driving Points
Volunteering Prior to First Court Date
8-Hour Driver’s Manual / 3-Test DMV Failure (18+)
Driver's Education / Re-Examination (3-Test DMV Failure)
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Requested Driver Improvement CourseDuring COVID-19, Driver Improvement classes continue to be held every Monday, Wednesday and Saturday. Doors open for each course at 8:30 am on the day of class and certificates will be received on the same day. Note: While registrations are not required and walk-ins are accepted, paid online registrations will receive priority until our class max is reached.
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Requested 8-Hour Driver's Manual CourseCDIC’s one-day, 8-Hour Driver's Manual class will be offered on the second Friday and the third Sunday of every month during COVID-19. Doors open for this course at 8:30 am on the day of class and certificates will be received on the same day. Note: While registrations are not required and walk-ins are accepted, paid online registrations will receive priority until our class max is reached.
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36-Driver's Education Classroom Instruction / Re-Examination (3-Test DMV Failure)For those under the age of 18 who either need to take the classroom portion for Driver's Ed and/or who have failed the learner's permit test three times. CLASSES ARE BEING HELD JULY 20TH - JULY 30TH FROM 2PM - 6PM.
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Additional Questions?
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My CoursesChoose your course below. Note: While payment is not required at this time, paid online registrations will be prioritized until the class maximum size is reached.
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$20
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Total costUSD
Driver Improvement (Court and DMV-Approved)The defensive driving course as ordered and/or accepted by the court, DMV, or insurance company.
$60.00Edit
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8-Hour Driver's Manual (3-Test DMV Failure) For those OVER the age of 18, who have failed the learner's permit test three times.
$120.00Edit
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36-Driver's Education Classroom Instruction / Re-Examination (3-Test DMV Failure)For those under the age of 18 who either need to take the classroom portion for Driver's Ed and/or who have failed the learner's permit test three times.
$180.00Edit
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Disposable Face MaskReminder: Face masks are required during class. Feel free to wear your own or purchase one with your order.
$1.50Edit
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Total cost $0.00
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