American Traffic Academy

Nevada:
702-272-1099

Arizona:
480-659-9102

American Traffic Academy - An Advanced Defensive Driving School

Court Appointed Students - Registration Form

Please fill out the form below to register for your Court Appointed Advanced Interactive Driver Education program. (Must show court papers on day of class.)

Take note of the following requirements:

You must register for your driving class within 48 hours of being assigned to this program. You will be provided with directions to the driving facility at time of enrollment.
You must complete your court mandated driving program within 90 days of your sentencing.
A parent or guardian must sign the accompanying Parental / Guardian Consent and Minor Liability waiver forms if you are under 18 years of age. For participants 18 years of age or older please complete the Adult Consent Release.
You must bring a valid, state or federally issued photo I.D. with you (drivers license, etc.). Failure to do so will result in forfeiture of your program fee! You will have to reschedule and pay the program fee again.
You must bring cash or a money order or a certified check payable to:

American Traffic Academy in the amount of $165.

NOTE: Failure to show up without providing at least 14 days notice will result in a $25 penalty to reschedule (No exceptions). There is NO fee for rescheduling outside of 14 days.

Failure to follow any one of these 5 simple steps will result in your being unable to participate in your driving program.

* Required Fields

First Name: *
Last Name: *
Age: *
Date of birth (mm/dd/yyyy): *	/ /
High School Currently Attending?
Do you have a valid drivers license? *	Yes Currently Suspended License
Parent Email Address: (if under 18 years old) AOL users may have difficulty receiving confirmation emails due to tight SPAM security measures.
Student Email Address: * AOL users may have difficulty receiving confirmation emails due to tight SPAM security measures.
Phone Number: *	()- -
Address: *
Address 2:
City: *
State: *
Zip Code: *
Court Appointed: *	Yes
Court Case Number: *
Describe your infraction:
Program Date: * Please only choose one program date.

Are there any other teenage drivers in your family?	Yes
Promotional code (if applicable):
Comments
Our programs are available to the general public. If someone else you know (parent, brother, sister, friend) is interested in joining you, they can also sign up for this same date. Cost is $195 per person.