Traffic School Registration Form Mchenry County printable pdf download

Traffic School Registration Form Mchenry County

T R A F F I C S C H O O L R E G I S T R A T I O N F O R M – M c H E N R Y C O U N T Y

T hi s f o r m mu s t be co mple t e d w h e n r eq ue st i ng Co u rt Su pe rv i sio n

Please mark your Class Preference (4-hour class)

Language Preference

Race/Ethnicity

Tuesday OR Thursday 8:00 a.m. – Noon

English

Asian/Pacific Islander

Tuesday OR Thursday 1:00 p.m. – 5:00 p.m.

Traffic Safety School reserves the

Spanish

Black/Non-Hispanic

Tuesday OR Thursday 6:00 p.m. – 10:00 p.m.

right to place you into a different

White, Non-Hispanic

Saturday 8:00 a.m. – Noon

Resident Alien

time & day on an as needed basis.

Saturday 1:00 p.m. – 5:00 p.m.

Hispanic

Native American/Alaskan

Online English

Online Spanish

______________________________________________________________________________________________

First Name

Middle Initial

Last Name

______________________________________________________________________________________________

Address

Apartment #

City

____________________________________(_____)____________________________________________________

State

Zip Code

Daytime Phone

Date of Birth (MM/DD/YY)

______________________________________________________________________________________________

Drivers License Number

State

FOR OFFICIAL

Case Number

Supervision Termination Date

USE ONLY

Traffic School Registration Form Mchenry County