Volunteer Driver Form



Name of Driver
Street Address
Mailing Address (if different)
City, State, Zip
Driver`s Licence Number
Phone Number
Cell Number
Year, Make & Model of vehicle
Licence Plate Number
Date of Expiration
Insurance Company Name
Policy Number
Policy Expiration Date
Please note: the minimal acceptable liability for privately-owned vehicles is $100,000/$300,000/$100,000
Liability Limits of Policy
In order to provide for the safety of our students or other members of the parish and those we serve, we must ask each volunteer to list all accidents or moving violations they have had in the last five years.
Accidents
Please be aware that as a volunteer driver, your insurance is primary.
 
Thank you for helping us with our transportation needs!
 
I certify that the information given on the form is true and correct to the best of my knowledge. I understand that as a volunteer driver, I must be 21 years of age or older, possess a valid driver's licence, have the proper and current license and vehicle registration, and have the required insurance coverage in effect on any vehicle used to transport students. Checking the Certification box will act as my signature.
Certification
Date
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