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8 Hour Online Drivers Improvement Program (DIP) Course
**PLEASE DOUBLE CHECK ALL INFORMATION TO ENSURE ACCURACY !!!!!!!!!!**
There is NO expediting online certificates. Your completion will be processed in
2-3 business days
and
CANNOT
be processed at all over the weekend
.
If you have a
CDL
(Commercial Driver's License) you are
NOT
eligible to take the Online Course! DO
NOT
PROCEED WITH THIS REGISTRATION FORM! You can
ONLY
take the in-person class.
IF YOU HAVE FAILED 3 TIMES AT DMV - THIS IS NOT THE CORRECT COURSE! PLEASE SIGN UP FOR THE
RE-EXAMINATION/DRIVERS MANUAL COURSE.
Does the student have any Language Concerns?
Yes
No
Language Differences
Should anyone have any language concerns, please
DO
NOT
proceed forward! This course is only in ENGLISH or SPANISH!
Reason for Class
Voluntary (To Receive 5 good points OR preparation for upcoming court date)
DMV Required (DMV Issued letter ordering this class)
Court Ordered (A Judge ordered you to take this class - or a lawyer - No Safe Driving Points Awarded.)
By selecting court I understand I will not receive any positive safe driving points.
Yes
No
Court Ordered
STOP!!! Please select Voluntary to receive any + safe driving points (if your eligible).
Student Information
First Name
Middle Name
Last Name
Street Address
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
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
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip Code
Date of Birth
MM/DD/YYYY or MM-DD-YYYY
Gender
Male
Female
Type of License
Regular License
Learners Permit
Customer ID Number (Drivers License Number)
Number looks like A00-00-0000
Upload an image of your Driver's License / Permit
Must be .jpg .pdf or .gif (DO NOT upload .heic file)
Upload an image of your DMV letter or Court order or Attorney letter
Must be .jpg .pdf or .gif (DO NOT upload .heic file)
Cell Phone
Home Phone
Email
Confirm Email
You have read and acknowledge the 6 Points listed under 'Course Information' for this class
YES
https://aadrivingacademy.net/online-course/
You confirm that you do NOT have a CDL (Commercial Driver's License)
YES
Payment $80.00
**No Refunds After 90 Days** **THIS CLASS MUST BE PRE-PAID**
Fee $80.00
(as of 11/2/2022)
Cardholder's Full Name:
Cardholder's Email:
Credit Card #:
CVC Code:
3 digit code on card
Card Exp Month:
(mm)
Card Exp Year:
(yyyy)
**PLEASE DOUBLE CHECK ALL INFORMATION TO ENSURE ACCURACY !!!!!!!!!!**
Contact Information