Course Completion Certificate Request
Only complete this form AFTER your 6th BTW lesson, all 30 hours of Classroom are complete and No Balances due.
Email address *
Student First Name *
Your answer
Student Last Name *
Your answer
Instruction Permit Number (DL #) *
On your PERMIT the Number just below your Signature, looks like this A999-9999-9999-99
Your answer
Email Address to send Confirmation to: *
Your answer
Phone Number *
Your answer
Road Test date (or none) *
Your answer
Date of your 6th BTW Lesson)? *
Who was your instructor at your 6th BTW Lesson? *
NOTE: If you have NOT completed all of your Classroom session including any make up classes or all of your BTW Lessons STOP here and submit this AFTER you complete. Otherwise: I, the above student, certify that I have completed 30 hours of classroom, 6 hours of Driving Behind the Wheel and 6 hours of Observation. *
I understand that my completion will be submitted directly to the DMV computer system and it can take 1-2 business days to transmit you information to them. If your road test is TODAY or TOMORROW send us an email right now to prompt us to get your info submitted. *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms