SOUTHERN ILLINOIS DRIVING SCHOOL

GRADUATE TO SAFETY – LOST CERTIFICATE REQUEST

PLEASE PRINT

TODAY'S DATE

Please read before you fill this out

The fee for a duplicate Graduate to Safety certificate is $35.00, paid in full online. We mail your certificate to the address you give below.

Your request is not complete until the fee is paid. We issue the duplicate after your payment arrives.

Fill out the form below, then tap Send my request and pay $35.00 at the bottom. Your information goes to the school and then you pay safely on PayPal.

Your information

Full name (as it was on the certificate)

Date you took the class (required – we need it to find your record)

Phone

Email Address

Where should we mail your certificate?

We mail your duplicate certificate to you. Please give your complete mailing address.

Street Mailing Address

City

State

Zip

Questions?

Call (618) 509-0224. The phone is answered 24 hours a day.

Send your request and pay

This sends your information to the school, then takes you to PayPal to pay the $35.00 fee in full. You do not have to type your name again on PayPal.

Print, save or send

When you are done, print it, save a copy, or email it to the school ahead of time. Remember, the lost-certificate request is not complete until the $35.00 fee is paid.