AL DMV Enrollment Verification

ALABAMA LAW ENFORCEMENT AGENCY ENROLLMENT / EXCLUSION FORM

To Implement Sections 16-28-40 through 16-28-45. Code of Alabama, 1975
Type all information as it should appear on your form. Please remember to capitalize.
Student Sex*
Student Last Name*
Student First Name*
Middle Initial ONLY
Date of Birth*

MonthDayYear
Date
Street*
City*
State*
Zip*
Parent Email*
example@example.com
Requesting Parent Name*

First NameLast Name
Parent Driver's License Upload (for verification of identity)*

Cancelof
Discipline Points
Today's Date

MonthDayYear
Date
My Products*
prevnext( X )
DMV Form (2 week turnaround time)
$ Free

EXPRESS DMV Form (2 day turnaround time)
$25.00

Total

$0.00

Payment Methods

Debit or Credit Card

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