Student's Information Form

 

Please fill-up the form very carefully. We will issue and mail certificates based on information  provided on the form. If you have any questions, please contact us at (619) 282-7900,  M-F 10Am-5Pm. Please indicate, in the field below, what type of certificate you are requesting;  Enrollment Certificate OL392, or Replacement Certificate for Driver Ed or Driver Training.

 

Type of the certificate requested:  

First Name:     

Last Name:      Date of Birth:     

 

Street Address:             City:           

               State:        Zip Code:         Home Telephone: