Student Registration

Student Legal Name(Required)

First Middle Last

Birthdate(Required)

Gender(Required)

Purpose of Certificate(Required)

I am under 18 years of age

I am over 18 years of age

Limited Term License Applicant (I am in OH for a limited amount of time)

OH Requires a purpose of certificate. Please select from one of the options above.

Student Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Password(Required)

Enter Password Confirm Password

Phone(Required)

Pre-Registration Code(Required)

Please Note: After clicking the Submit button, it is CRITICAL to click the "Finish Student Registration" button on the next page.

Your student registration is not valid without completing the next page and clicking "Finish Student Registration".

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