Bay Area Driving School
Traffic School Application

Directions:
1) Print this form, 2) Fill in your information, 3) Fax to (510) 886 - 4408 and call with your credit card number

or Mail to (with deposit; call for amount):

Bay Area Driving School
1070 A Street
Hayward, CA 94541

If you have questions, please call (510) 886-1016
Complete Legal Name: (Please Print Legibly)
First:
Middle:
Last:
Address:
City:
Zip Code:
Home Phone:
Birthday:
Cell Phone:
Case/Docket No:
Driver Licese No:
Completion Due Date:
Court Referred By:
Total Hours of Instruction: 8
Date you would like to start class:

No Refunds

Please do not write below this line
For Office Use Only
Date Paid Amount Paid
Check No. Cash Receipt No.
Visa/MC Exp.
Card Holder Name
Payment #2 Date

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