Segment 2 certificate number(2):________________________________
Driver Education Code on white card(3):________________________
Segment 2 Completion Date(4):__________________________________
Vehicle Year:________________ Make:_______________________________
Model:_______________ Plate Number:______________________________
Car Insurance Company Name:___________________________________
Insurance Expiration Date:________________________________________
On the day of your test, please bring ALL supporting documents and certificates used to fill out this form so the information can be verified. Thank You!
(2) This red number will be in the top right corner of the Segment 2 certificate of completion white card. For example, X134234.
(3) This should be on the WHITE Segment 2 Driver Education certificate of completion certificate. It is usually a letter followed by a 2 digit number. For example, 212 or B12.
(4) This should be on the WHITE card received after completing the 6 hours of Segment 2 class work. Buy Road Test on Square Market