Certificate of School Enrollment Request

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please complete this form to request a Certificate of School Enrollment for purposes of obtaining your learner's permit or driver's license. Request must be made within 30 days of your appointment at the Dept. of Driver Services or form WILL NOT be valid.

Student's First & Last Name as listed on school records *

Student's Date of Birth *

YYYY

Address to be listed on form *

Email Address - completed form will be sent to this email. Please make sure it is accurate. *

Appointment Date - Must be within 30 days of request date. *

YYYY

Please click here if you also need a copy of your Alcohol & Drug Awareness Program (ADAP) Completion Certificate. Note: We will only have access to this if the course was taken and passed at Clarke Central High School. Please leave this response blank if you do not need it.

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Clarke County School District. Report Abuse

Forms