Enrollment Process

Please answer this two questions:

Is this your first DUI arrest?

Yes

Have you previously completed a DUI course?

Yes

* First Name:

Middle Name:

* Last Name:

* E-mail Address:

* User Name:

* Password:

* Cell Phone Number:

Home/Work Phone:

* Address:

* City:

* State:

* Zip Code:

* County:

Emergency

Contact:

Emergency Phone:

Relation:

*Choice of Location:

* Social Security #:

Driver Licence # (no dashes / spaces):

* Date of Birth:

* Gender:

Country of employment or school attendace:

Language:

Client's Attorney

Full Name:

Phone Number:

CANCEL

Next Step