POINT SYSTEM CONFERENCE/DRIVER IMPROVEMENT PROGRAM

ONLINE ENROLLMENT FORM

Remember that this form is used to enroll in our online course. In order to fulfill your MVA requirement you must be tested and pay your fee upon completion at one of our locations.

Please fill out all your information on the enrollment form or your registration will be considered incomplete.

Name
Address
City
State
Zip
DOB (Date of Birth) - -   (ex. MM-DD-YY)
Drivers License Number - - - -
Home Phone 
Business Phone
E Mail
PSC or DIP
Preferred Testing Location / County 

 

"WidmyerDriving School..over 25 years of excellence in safety education"

Widmyer.com

162 WestWashington  St

Hagerstown,Md. 21740