Fleet Payment Form - DriveSafe Online®

Quantity (5-250)(Required)

Please enter a number from 5 to 250.

Call 1-888-403-1452 if you need 250+ courses

Fleet Driver Safety Courses

Price:

Quoted a lower price? We price match. Call us for details.

Total

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Company or Organization(Required)

Job Title

Phone(Required)

Extension

Are you an existing customer?

Check here if yes.

Enter your organization's coupon code.

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Address(Required)

Street Address Address Line 2 City State ZIP Code

Enter an email address where a copy of the driver's completion certificate will be sent (examples: HR, fleet manager, training manager, etc.)

Enter Email Confirm Email

Which course will your drivers primarily use?(Required)

Check here if any of your students will need our 1-hour or 4-hour Spanish language course:

Need 1-hour Spanish instructions

Need 4-hour Spanish instructions

Need instructions for both

Do you want timers in your courses? (Timers ensure users cannot skip any video content.)(Required)

Yes

No

Comments or Special Instructions

Where did you hear about DriveSafe Online?

Fleet Purchase Form