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Enrollment for Safety-Ed™ California Traffic School
 
Step 2: Your Enrollment Information
* Denotes a Required Field
Your Name*
Use your Exact Full Name as it appears on your Drivers License:
Last:  
First:  
Middle:  
 
Your Email Address
Please enter an email address we can use to send you a Registration Confirmation when your course registration is complete.
Email:  
 
Your Driver's License Number *
Your Driver's License will serve as your Login Name when entering the Course Module.
DL State:       
DL Number:  
 
Your Password *
Please select a password you will use to access the Course.
We recommend a password of 6-8 characters, at least 1 being a number.
Password:                  
Confirm Password:  
 
Password Reminder *
Please select a Password Reminder Question below, and provide an answer to the question you have selected.
We'll use these to assist you if you ever forget your password.
Question:  
Answer:     
 
Your Gender*
Your Gender as it appears on your Drivers License:
 
 
Your Date of Birth *
Your Date of Birth as it appears on your Drivers License:
mm/dd/yyyy format
 
The County/Court where you received your ticket: *
If you are taking this Course for ticket dismissal, please refer to your ticket and Court documentation to complete the Court information below.
If you are taking this course for an Insurance Discount only, check the applicable box.
No ticket dismissal - insurance discount only
County: Court:
 

  
Court Division: Case Number: Course Due Date:  
mm/dd/yyyy format
 
Ticket Due Date
Due Date:     mm/dd/yyyy format
I don't know my due date.
SUSA Online Driving Services LLC Student Enrollment Form and Agreement