Volunteer Driver Form

Name of Driver*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Driver's License Number
Home Phone Number*
Cell Phone Number*
Year, Make & Model of Vehicle*
License Plate Number
Date of Expiration
MM slash DD slash YYYY
Insurance Company Name*
Policy Number
Policy Expiration Date
MM slash DD slash YYYY

Please note: the minimal acceptable liability for privately-owned vehicles is $100,000/$300,000/$100,000
Liability Limits of Policy
Accidents*
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.
Volunteer Driver Consent
Please be aware that as a volunteer driver, your insurance is primary. Thank you for helping us with our transportation needs!
Checking the Certification box will act as my signature.*
Certification
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 license, have the proper and current license and vehicle registration, and have the required insurance coverage in effect on any vehicle used to transport students
Date*
MM slash DD slash YYYY
CAPTCHA

Volunteer Driver Consent