Defensive Driving (4-Hour, Online) Registration From
Please complete this form to register for our 4-Hour Defensive Driving Program (held via Zoom) or call our office during business hours at 816-836-2220.
Please select the date and time you'd like to register for:
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Wednesday, June 17, 2026 at 6:00 p.m.
Name
*
First Name
Last Name
Date of Birth
*
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Month
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Day
Year
Date
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Area Code
Phone Number
Email
*
example@example.com
What Court do you want us to send your completion to, if any?
What was your ticket for? (Speeding, Careless & Imprudent, etc.)
What attorney or probation officer do you want your completion to go to, if any?
Program Fee - If you would like to pay via money order, please contact Midwest ADP at 816-836-2220 during office hours of 8:30 a.m. - 5:00 p.m. and we can handle your registration over the phone
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Defensive Driving Class - 4 hours
$77.55
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77.55
Defensive Driving Class - 4 hours
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