Alcohol remedial form 2025

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The document is a verification form for out-of-state petitioners who have completed alcohol/drug remedial education as required by the Illinois Secretary of State. It includes sections for petitioner information, details of the remedial education completed, and instructions on the curriculum and testing requirements for the program.

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Click ‘Get Form’ to open the alcohol remedial form in the editor.
In Section I, enter your personal information. Fill in your name (Last, First, Middle), Illinois Driver’s License Number, address (Street/City/State/ZIP), sex (M/F), date of birth, and both home and work telephone numbers.
Proceed to Section II for Remedial Education Verification. Indicate the total hours of alcohol/drug education completed and whether a pre-test and post-test were administered. Record the pre-test and post-test scores as percentages.
Fill in the dates when remedial education began and was completed. Ensure all information is accurate.
Finally, have an authorized program representative sign the form, providing their title, telephone number, program name, accreditation/license number, and address.

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