You are registerning with All American Driver Improvement, for a webinar type virtual classroom setting.  In the classroom classes are canceled until restrictions are lifted.

Please complete the form completely and accurately.   You will recieve class preparation instructions in a later email.

Your Reason for Class-> 4 or 8 hour	Why are you taking this class?	8 hr Reinstatement-Excessive points TN Dep-Safety & HS 4 hr County or City Judge to prevent points 8 hr County or City Judge to prevent points 4 hr out of state tickets or other (explain in comments) 8 hr out of state tickets or other (explain in comments) Other reasons-(explain in comments)
Choose Your Class Date	chosen date to attend the virtual class	July 11 virtual class July 18 virtual class Aug 8 virtual class Aug 15 virtual class
FIRST name
MIDDLE name
LAST name
Date of Birth - MONTH		- - Choose One - - Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
Date of Birth - DAY		- - Choose One - - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Date of Birth - YEAR		1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Driver's License Number for CERTIFICATE
State Where License Issued
Cell phone for text class reminder
Back-up phone home / friend / relative
Student's Email for ZOOM link and reminder	must be a good e-mail address to receive your confirmation message
Comments:	explain or enter your comments here
Security Code (CASE sensitive)	enter security code (CASE sensitive)