Please complete and submit the form below.
We prefer a certified copy of your driving record be submitted with this application however if this is not possible it must be submitted prior to testing. Any
application not including a copy of your driving record will not be considered.
If you would like to claim veteran's preference, documentation must be submitted with this application. See brochure for more information. Please do not upload any documents except those which provide verification of military duty for veteran's preference.
To protect sensitive information, we do not request Social Security numbers or driver’s license numbers on this online form. A driving record may be subsequently requested and will be reviewed for insurability purposes, as well as your driving record in other states. Please complete the information below.
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If you do now know the exact date, please list the month/year in which you think the test was taken.
Please check one of the descriptions below corresponding to the ethnic group with which you identify.
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