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Request Traffic School Form

"*" indicates required fields

Name*
MM slash DD slash YYYY
Address*
I have read the Traffic Safety Education Program conditions.*
I have read the Traffic Safety Education Program eligibility requirements.*
I choose to enter a plea of NO CONTEST to the violation(s) on the citation listed above.*
I am requesting to sign up for the Traffic Safety Education Program.*
This field is for validation purposes and should be left unchanged.