Form P-225 Application for Special Operator's Permit for Higher Education or Private Occupational School - Connecticut

Form P-225 or the "Application For Special Operator's Permit For Higher Education Or Private Occupational School" is a form issued by the Connecticut Department of Motor Vehicles.

Download a PDF version of the Form P-225 down below or find it on the Connecticut Department of Motor Vehicles Forms website.

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APPLICATION FOR SPECIAL OPERATOR'S
STATE OF CONNECTICUT
PERMIT FOR HIGHER EDUCATION OR
DEPARTMENT OF MOTOR VEHICLES
PRIVATE OCCUPATIONAL SCHOOL
DRIVER SERVICES DIVISION
On The Web At: ct.gov/dmv
P-225 Rev. 9-13
INSTRUCTIONS:
1.
A separate application and a completed release under the Family Education Rights and Privacy Act is required for each institution.
2.
Please print or type, original signatures required.
3.
A $100.00 non-refundable application fee in the form of a check or money order payable to DMV must accompany each request for a permit.
4.
Complete section A, B and C and mail original to DMV, Driver Services Division, 60 State Street, Wethersfield, CT 06161.
Your driving history will be reviewed as part of this application. Operation of motor vehicles requiring a commercial driver's license or used for
Public Passenger Transportation is prohibited under the special permit program.
A. APPLICANT INFORMATION
NAME OF APPLICANT
DATE OF BIRTH
STATE / OPERATOR LICENSE NUMBER
MALE
FEMALE
ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
NON-PERMANENT STUDENT RESIDENCE ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
HOME TELEPHONE NUMBER
CELL PHONE NUMBER
EMAIL ADDRESS
(
)
(
)
@
THIS PERMIT WILL ONLY BE VALID FOR CLASSES AND EXAMINATIONS AT AN ACCREDITED INSTITUTION OF HIGHER LEARNING OR
PRIVATE OCCUPATIONAL SCHOOL
B. INSTITUTION OF HIGHER LEARNING INFORMATION
NAME
STUDENT IDENTIFICATION NUMBER
ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
C. Attach a certified copy of your class and examination schedule clearly identifying the days, hours and geographic locations.
This information will be confirmed with the registrar. Attach additional information as necessary.
/
/
/
/
MM
DD
YYYY
MM
DD
YYYY
Start date of classes or examinations
End date of classes or examinations
APPLICANT MUST REPORT ANY SCHEDULE CHANGE TO DMV, DRIVER SERVICES DIVISION WITHIN 72 HOURS
The distance and commuting time from your student residence to the location of your classes or examinations
miles
hours/minutes
Is public transportation available from your student residence to your class locations?
YES
NO
What significant hardship will you suffer without an educational permit?
What efforts have you made to obtain other transportation?
INABILITY TO CONFIRM ABOVE INFORMATION MAY RESULT IN THE DENIAL OF YOUR SPECIAL OPERATOR'S PERMIT.
NOTICE: Your operator's license is under suspension. If you operate any motor vehicle outside of the authorized hours, you may be subject to arrest. If you operate a motor vehicle
for a purpose not authorized by law, a law enforcement officer may make a report to the Commissioner of Motor Vehicles and you will be subject to a civil penalty of up to $500.00.
If your operator's license is suspended for another reason while you are in possession of this permit, the permit is revoked and if you thereafter operate a motor vehicle you will be
subject to double the license suspension penalties imposed by law. If you alter or make improper use of the permit, you will be subject to criminal penalties and the permit may be
revoked.
APPLICANT OATH: I swear or affirm under penalty of false statement in accordance with Connecticut General Statutes §14-110 and §53a-157b, and subject
to penalties for perjury for a deliberate false statement, that I am enrolled at this institution of higher education and the certified class and examination
schedule information and all attachments hereto are true and correct.
PRINTED NAME OF APPLICANT
SIGNATURE OF APPLICANT
DATE SIGNED
REGISTRAR OATH: I swear or affirm under penalty of false statement in accordance with Connecticut General Statutes §14-110 and §53a-157b, and subject
to penalties for perjury for a deliberate false statement, that the above named applicant is enrolled in this institution of higher education or private occupational
school and the certified class and examination schedule information is true and correct.
PRINTED NAME OF REGISTRAR OR DESIGNEE
SIGNATURE OF REGISTRAR OR DESIGNEE
TITLE OF PERSON CONFIRMING SCHEDULE TELEPHONE NUMBER
(
)
DMV USE ONLY
D.
PERMIT:
APPROVED:
EFFECTIVE DATE
PERMIT EXPIRATION DATE
LICENSE EXP. DATE
DENIED:
DRIVING HISTORY
NO SIGNIFICANT HARDSHIP
INELIGIBLE
UNABLE TO CONFIRM INFORMATION
OTHER:
EXPLAIN
AUTHORIZED DMV SIGNATURE
PRINTED NAME
DATE
APPLICATION FOR SPECIAL OPERATOR'S
STATE OF CONNECTICUT
PERMIT FOR HIGHER EDUCATION OR
DEPARTMENT OF MOTOR VEHICLES
PRIVATE OCCUPATIONAL SCHOOL
DRIVER SERVICES DIVISION
On The Web At: ct.gov/dmv
P-225 Rev. 9-13
INSTRUCTIONS:
1.
A separate application and a completed release under the Family Education Rights and Privacy Act is required for each institution.
2.
Please print or type, original signatures required.
3.
A $100.00 non-refundable application fee in the form of a check or money order payable to DMV must accompany each request for a permit.
4.
Complete section A, B and C and mail original to DMV, Driver Services Division, 60 State Street, Wethersfield, CT 06161.
Your driving history will be reviewed as part of this application. Operation of motor vehicles requiring a commercial driver's license or used for
Public Passenger Transportation is prohibited under the special permit program.
A. APPLICANT INFORMATION
NAME OF APPLICANT
DATE OF BIRTH
STATE / OPERATOR LICENSE NUMBER
MALE
FEMALE
ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
NON-PERMANENT STUDENT RESIDENCE ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
HOME TELEPHONE NUMBER
CELL PHONE NUMBER
EMAIL ADDRESS
(
)
(
)
@
THIS PERMIT WILL ONLY BE VALID FOR CLASSES AND EXAMINATIONS AT AN ACCREDITED INSTITUTION OF HIGHER LEARNING OR
PRIVATE OCCUPATIONAL SCHOOL
B. INSTITUTION OF HIGHER LEARNING INFORMATION
NAME
STUDENT IDENTIFICATION NUMBER
ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
C. Attach a certified copy of your class and examination schedule clearly identifying the days, hours and geographic locations.
This information will be confirmed with the registrar. Attach additional information as necessary.
/
/
/
/
MM
DD
YYYY
MM
DD
YYYY
Start date of classes or examinations
End date of classes or examinations
APPLICANT MUST REPORT ANY SCHEDULE CHANGE TO DMV, DRIVER SERVICES DIVISION WITHIN 72 HOURS
The distance and commuting time from your student residence to the location of your classes or examinations
miles
hours/minutes
Is public transportation available from your student residence to your class locations?
YES
NO
What significant hardship will you suffer without an educational permit?
What efforts have you made to obtain other transportation?
INABILITY TO CONFIRM ABOVE INFORMATION MAY RESULT IN THE DENIAL OF YOUR SPECIAL OPERATOR'S PERMIT.
NOTICE: Your operator's license is under suspension. If you operate any motor vehicle outside of the authorized hours, you may be subject to arrest. If you operate a motor vehicle
for a purpose not authorized by law, a law enforcement officer may make a report to the Commissioner of Motor Vehicles and you will be subject to a civil penalty of up to $500.00.
If your operator's license is suspended for another reason while you are in possession of this permit, the permit is revoked and if you thereafter operate a motor vehicle you will be
subject to double the license suspension penalties imposed by law. If you alter or make improper use of the permit, you will be subject to criminal penalties and the permit may be
revoked.
APPLICANT OATH: I swear or affirm under penalty of false statement in accordance with Connecticut General Statutes §14-110 and §53a-157b, and subject
to penalties for perjury for a deliberate false statement, that I am enrolled at this institution of higher education and the certified class and examination
schedule information and all attachments hereto are true and correct.
PRINTED NAME OF APPLICANT
SIGNATURE OF APPLICANT
DATE SIGNED
REGISTRAR OATH: I swear or affirm under penalty of false statement in accordance with Connecticut General Statutes §14-110 and §53a-157b, and subject
to penalties for perjury for a deliberate false statement, that the above named applicant is enrolled in this institution of higher education or private occupational
school and the certified class and examination schedule information is true and correct.
PRINTED NAME OF REGISTRAR OR DESIGNEE
SIGNATURE OF REGISTRAR OR DESIGNEE
TITLE OF PERSON CONFIRMING SCHEDULE TELEPHONE NUMBER
(
)
DMV USE ONLY
D.
PERMIT:
APPROVED:
EFFECTIVE DATE
PERMIT EXPIRATION DATE
LICENSE EXP. DATE
DENIED:
DRIVING HISTORY
NO SIGNIFICANT HARDSHIP
INELIGIBLE
UNABLE TO CONFIRM INFORMATION
OTHER:
EXPLAIN
AUTHORIZED DMV SIGNATURE
PRINTED NAME
DATE

Download Form P-225 Application for Special Operator's Permit for Higher Education or Private Occupational School - Connecticut

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