Registration forms

General Form

Who should use this form: 
1) Voluntary participants. 
2) Drivers who have received a single traffic ticket outside of Champaign, Douglas, or Piatt counties and would like to attend the 4-hour National Safety Council defensive course at Parkland College.

You may also complete the registration form online by clicking here

Use this form for these classes: DDC-4, Online DDC-4 or "Alive at 25"

Champaign County Form

Who should use this form:
1) Drivers who have received a single traffic ticket in Champaign County and would like to participate in the Traffic Safety Program.

Use this form for these classes: DDC-4, Online DDC-4 or "Alive at 25"

Douglas County Form

Who should use this form:
1) Drivers who have received a single traffic ticket in Douglas County and would like to participate in the Traffic Safety Program.

Use this form for these classes: DDC-4, Online DDC-4 or "Alive at 25"

Piatt County Form

Who should use this form:
1) Drivers who have received a single traffic ticket in Piatt County and would like to participate in the Traffic Safety Program.

Use this form for these classes: DDC-4, Online DDC-4 or "Alive at 25"

"Graduate to Safety" Form (Suspended License)

Who should use this form:
1) Drivers 16-21 years old who have had their license or permit suspended by the Illinois Secretary of State.

You may also complete the registration form online by clicking here

Use this form for this class: "Graduate to Safety"

Click the following link to review a list of all Illinois State Approved Driver Retraining Programs