DR 2643 Affidavit of Enrollment Level II Drug and Alcohol Education and Treatment If you are using a-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name and date of birth in the designated fields. Ensure that the information matches your official documents.
3. Input your Colorado PIN, followed by the date of admission to the program. This is crucial for tracking your enrollment status.
4. Fill in the agency name and agency ID, along with the track assigned to you. This information helps identify your specific program.
5. Have an authorized staff member sign in the appropriate section, then enter their contact number and estimated date of completion.
6. Finally, review all entered information for accuracy before signing as the applicant and dating the form.

Start filling out your DR 2643 form today on our platform for free!