(If you have signed up and paid for a class, but now have to reschedule your class date, please call our office at (816) 842-5223 Ext. 1.)

You are enrolling in the Safety and Health Council of Western MO and KS
Traffic School

Choose your class below.
Please fill out all required fields.
We will contact you when your payment has been processed.

Students Name:

First Name

Last Name

Students Birthday

Daytime Phone

Students Address:

Address

Zip

City

State

CC Billing Info:

Why do i Need This? Credit card companies require this to validate your card and should only contain the CC Address and Zip Code on the Card, NO Apt# or Building# NO '#' or other Special CHARS, they are not required or permitted, and cannot be processed by our Gateway Provider.

CC Billing Address

CC Billing Zip

Which Class do you need to Take?

Please Choose Class Alive @ 25 DDC 4-Hour DDC 8-Hour MO Drivers Permit Academy

Room #

N/A

Ticket & Class Additional Info:

Ticket# (If Applicable)

Offense State

Drivers License#

Ticket & Class Additional Info:

I agree that registration is non-refundable.

Student Name:

First Name

Last Name

Students Birthday

Daytime Phone

Student's Address:

Address

Address2

Zip

City

State

CC Billing Info:

CC Billing Address

CC Billing Zip

Selected Class Info:

Selected Class

Fee Due Today

Selected Location

Class Address

Selected Date

Payment Status:

Date Paid:

Class Additional Info:

Ticket# (If Applicable)

Offense State

Name of Court:

Drivers License#

I agree that registration is non-refundable.

Terms and Conditions

I understand that if I do not attend the entire class on the above date and time for any reason, I forfeit the pre-payments made. It is at the discretion of the Safety and Health Council if I will be allowed to reschedule for an additional date. I understand the class must be completed within a restricted time frame. I understand that if I do not complete the program, I will receive NO REFUND. Call 816-842-5223 to reschedule. No guests allowed

Your e-sign SIGNATURE, indicating that you agree to these terms and conditions:

Safety and Health Council of KS & MO

(If you have signed up and paid for a class, but now have to reschedule your class date, please call our office at (816) 842-5223 Ext. 1.)

You are enrolling in the Safety and Health Council of Western MO and KS
Traffic School

Terms and Conditions

Terms and Conditions

Contact Safety Council

Useful Links

(If you have signed up and paid for a class, but now have to reschedule your class date, please call our office at (816) 842-5223 Ext. 1.)

You are enrolling in the Safety and Health Council of Western MO and KSTraffic School

Terms and Conditions

Terms and Conditions

Contact Safety Council

Useful Links

Newsletter Signup

You are enrolling in the Safety and Health Council of Western MO and KS
Traffic School