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Please fix the highlighted areas below before submitting.

Application for Driving School Bus

All approved driver must:

1. be between the ages of 25 and 65

2. have a valid driver’s license with no restrictions other than glasses or outside right mirror

3. have no major traffic violations (reckless driving, driving under the influence, fleeing scene of accident)

4. not have more than one at-fault or one minor traffic violation in the last three years

5. be covered by a current vehicle insurance policy

6. have a copy of driver’s license and current insurance card on file in the school office

Please complete the form below. Required fields marked with an asterisk *

Name: (First, Middle, Last)*

Answer required for "Name: (First, Middle, Last)"

Date of Birth:*

Answer required for "Date of Birth:"

Cell Phone*

Answer required for "Cell Phone"

Driver's License Number and Expiration*

Answer required for "Driver's License Number and Expiration"

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Commercial Driver's License*

Answer required for "Commercial Driver's License"

Yes

Major Traffic Violations: If Yes, please explain below.*

Answer required for "Major Traffic Violations: If Yes, please explain below."

Minor Traffic Violations in Last 3 Years?*

Answer required for "Minor Traffic Violations in Last 3 Years?"

Yes

Not At-Fault Accidents in Last 3 Years?*

Answer required for "Not At-Fault Accidents in Last 3 Years?"

Yes

At-Fault Accidents in Last 3 Years?*

Answer required for "At-Fault Accidents in Last 3 Years?"

Yes

Please explain any accidents in the last 3 years:*

Answer required for "Please explain any accidents in the last 3 years:"

Insurance Provider and Policy Number:*

Answer required for "Insurance Provider and Policy Number:"

Agreement*

Answer required for "Agreement"

To the best of my knowledge, all the above information is accurate.

Full Name, Time, and Date*

Answer required for "Full Name, Time, and Date"