Defensive Driving Course Online Registration

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Defensive Driving Course Online Registration

Staying Safe On The Road

Defensive Driving Training is a mandatory requirement for any Western New England University student, faculty, volunteer or staff member who wishes to operate a vehicle on behalf of the University.

Please allow for at least two weeks for processing your driver certification until you are eligible to drive on behalf of the University.

Instructions

Fill out form below (All Fields are Required)
Accept the terms and conditions
Submit the form

Driver's Name:
License Number:	DOB:
State:	Expiration:
Home Address:
School Address:
Email Address:
Have you applied for driver authorization previously? Yes No

Why do you require use of a University vehicle? (Please select only one):

Faculty Staff Student Volunteer Other

What is your purpose for driving University vehicles? (Please select only one):

Position Required Conference/Meetings Athletics Field Trips Volunteer Programs Education Programs

Who is your Department Head or Group Leader:

I accept and agree to the terms and conditions set forth in the Western New England University Vehicle Policies and Procedures.

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1215 Wilbraham Road, Springfield, MA 01119

800.325.1122 • 413.782.3111

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