DOT Enrollment and Submission Form (2023)

Name *

First

Middle

Last

Current Residential Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Enter your current email address

Phone Number *

Please enter your current phone number

Are you associated with a company or school? *

College
Online Refresher
Company

Select one of the (3) options that applies to you

Attach CDL *

Click or drag a file to this area to upload.

Please attach a copy of your CDL for the course.