First Name
E-Z PURCHASE - WORKBOOK
 Last Name
Fill out ALL info-fields as They are court required
Street Address
Please do not use ENTER KEY To move between fields
City
the ENTER KEY ERASES DATA.
 State
Use < TAB KEY > to move field to field for data entry
Zip Code
located on the left side of your keyboard for data entry
 Phone Number

- - (MM-DD-YYYY) Birthday

ANY PROBLEM call toll-free
 Your Email
888-822-0008 - 7 DAYS a WEEK 7 am 8 pm
Case Number
Your questions will be promptly and courteously answered
 Drivers Lic #
State of Drivers License

Important : COURT Name

Be sure that one is selected from drop down menu

After payment use your email and the password
you created to log in and out until course completed

- - Due Date (MM-DD-YYYY)

Password

click CONTINUE to reach the secure payment screen

Repeat Password Carefully

start course IMMEDIATELY after PAYMENT VIA credit card

VISA or MASTERCARD ONLY
$33 + Sales Tax + Priority US Mail
2-3 day delivery time Total cost $39.95

You will be asked to confirm and pay via credit card


I am the person who has received the offending ticket for this course and am the person completing this course online. Check the box to the right
yes

Credit card transaction is SECURE and PRIVATE

Instant refund for any reason upon request

Be Careful This clears all infomation entered THANK YOU

For your security we secure your data using Secure Socket Layer (SSL) 3.0
encryption technology. This confirms that the becooltrafficschool.com, is a
licensee of the SSL Privacy Program. All Information is private and secure.

A Superior Court approved online Traffic School providing an 8-hour Certificate for the dismissal of a traffic ticket or citation.