Silver City DWI Registration - English

Name (First, Last, MI)

Mailing Address (Include City, State and Zip Code)

Email Address

Phone Number

Birthday

Month

Day

Year

Drivers License Number and State

Last 4 of Social Security Number

Referring Judge

Method of Payment

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Contractual Agreement: Please read and acknowledge. By typing your name below, you are agreeing to the following:

Payment must be made in full prior to being accepted into the class.
Once your registration is accepted, you must attend the assigned classes in your confirmation email. If you have registered for a course but fail to attend a $20 reschedule will be assessed on re-enrollment. If you begin the course but are not able to complete it, you will be assessed a $50 reschedule fee for each class you have to reschedule. (1 class = $50, 2 classes = $100)
Don't come to class under the influence of alcohol or drugs! If you are suspected of being under the influence, you will not be allowed into class and your compliance person will be notified. No refunds will be given.
No drugs, alcohol, smoking or vaping allowed on the property!
No eating in class. You are allowed to bring water to class provided it is in a resealable bottle or container.
Obey all posted signs on the property.
Don't be late! Once the doors are locked, you will not be allowed into class, No Exceptions. If you miss a class you must email us at eracorrespondence@gmail.com and reschedule. A $50 reschedule fee will be assessed.
Complete all assigned homework. As part of the course you will be required to complete some homework assignments. You will not be allowed into class if you haven't completed the homework and reschedule fees will apply.

Type your name