Violation- Distracted Driving Education Program Form

Please fill out the form below if you wish to participate in the Distracted Driving Education Program. We will respond to your request once we have received the citation from Hermiston Police Department.

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FIRST NAME *

LAST NAME *

DATE OF BIRTH

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MAILING ADDRESS *

CITY *

STATE *

ZIP CODE *

CITATION NUMBER (6 digits and starts with a "2" or a "5") *

Only citations issued by the Hermiston Police Department are filed with the Hermiston Municipal Court. If your citation number is not 6 digits, please contact the court listed at the bottom of the citation.

DATE OF OFFENSE *

EMAIL ADDRESS *

PHONE NUMBER *

I choose to enter a plea of NO CONTEST to the violation(s) on the citation listed above. *

Agree, I am entering a plea of No Contest.

Violation- Distracted Driving Education Program Form

Contact Information