Future Notification List for LA Driver's License Reinstatement Clinic - ALL APPOINTMENT SPOTS ARE FULL. If you did not receive a confirmation email or call, with an appointment time, please do not come to the event. Thank you for understanding.

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Cell phone

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* 5. Date of Birth MM/DD/YYYY

Date / Time

Date

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* 6. Full LA Driver's License Number (if you don't have it, put 0 here and your full social below).

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* 7. Last 4 Digits of Social (or full social if you don't have your DL number)

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* 8. Parish(es) with Outstanding Tickets

Gretna

Jefferson

Kenner

Orleans

St. Charles

St. John the Baptist

Other (please specify)