WCIP: Student Commercial Driving Registration Form

Please complete all of the *required fields in the below form in its entirety. Required documents should also be submitted with this form. SUNY Canton has partnered with the Workforce Development Institute, St. Lawrence County Career Centers and St. Lawrence County IDA, for program development and possible training funds.

If you have any questions, please contact us at wcip@canton.edu.

First Name*

Middle Name

Last Name*

Birthdate*

Mailing Address*

Country

Street

City

Region

Postal Code

Phone Number*

Email Address*

Tuition cost is $7,000. Is financial assistance needed?*

Funding Agency

Driver's License (Class D) Number*

Proficient in shifting a manual transmission?* (You must be proficient in manual transmission before the first day of class. If you are not proficient in manual transmission, you are subject to being removed from the class after instructor assessment.)

CDL Permit*

Please attach Learner's Permit in PDF format here.

Driver's Abstract Date Acquired*

Please attach Driver's Abstract in PDF format here.

Date of DOT Physical*

Physical Results*

Please attach Physical Results in PDF format here.

Date of Drug Test*

Drug Test Results*

Please attach Drug Test Results in PDF format here.

Are you currently on any medication that can inhibit your driving?*

Is there any known reason, such as criminal history, etc., you would be denied a commercial driver's license?*

Where did you learn about this program?*

Admitted Students

Pay Your Deposit

Open House

Request Information

One-Hop Shop

Departments

WCIP: Student Commercial Driving Registration Form