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Replacement Card Order Form

ESC-20 Transportation Services

The cost for a replacement card (current or expired) is $20.00. Applies to all cards 30 days beyond the class date.

If you completed your session within the last 30 days, please disregard the fee. However, the form below still needs to be submitted. In the "reason for replacement card request" comment box, enter the dates of your class and/or session number.

This form needs to be completed for all requests, including name changes, errors, or any other changes that need to be made. (Please note reason for request on the form below.)

NOTE: Replacement cards are available only if you attended a certification class in REGION 20. Otherwise, you will need to contact the Region you last attended.

IF YOUR CERTIFICATION IS MORE THAN ONE (1) YEAR EXPIRED, YOU WILL NOT BE ELIGIBLE FOR THE RECERTIFICATION CLASS. YOU WILL NEED TO RE-TAKE THE CERTIFICATION CLASS.

Reason for Replacement Card request.*

Be specific. Include correct name, date of birth, etc.

Answer Required

Please complete the form below.

Required fields marked with an asterisk *

Texas Driver's License Number*

(Show all 8 digits)

Answer Required

The current/previous district or organization you work for:*

SAISD, Somerset ISD, Goldstar Transit, etc

Answer Required

Driver's Contact Information

First Name*

Answer Required

Last Name*

Answer Required

Date of Birth*

mm/dd/yyyy

Answer Required

Email*

Please ensure there are no extra spaces before or after the email address.

Answer Required

Phone Number*

Number Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Expiration Date of Current Card

mm/dd/yyyy

Answer Required

Confirmation Email

Email Required