Volunteer Driver Application Form

VOLUNTEER DRIVER APPLICATION FORM
We often need help in transporting students on field trips or for sports events. Our school parents have been generous in their assistance. The purpose of this form is to reduce the liability of the school and volunteer drivers by being proactive in our selection of parent drivers. If you are interested in helping with such needs during the school year, please fill out this form and return it (along with copies of your drivers license and your current vehicle insurance card) to the school. The Volunteer Driver Application Form is valid for one year from approval. All chaperones must also be Live Scan fingerprinted.
School Year
Select all campuses that your child(ren) are enrolled.*

PreschoolElementaryJunior High/High School
Volunteer Driver Information
Driver Name*

First NameLast Name
Email Address*
example@example.com
Home Phone Number*
Work Phone Number
Address*
Driver's License Number*
License Expiration Date*

MonthDayYear
Date
Upload Driver’s License*

Click to upload
Maximum upload size: 10MB Cancelof
Vehicle Information
Make of Vehicle*
Model*
Year*
Number of students you are able to transport with working seat belts (not including the driver)*
License number for car*
The school requires volunteer drivers to have a minimum amount of liability insurance. (1) $100,000 liability for bodily injury per person; (2) $300,000 liability per incident for bodily injury for all vehicle occupants; and (3) $50,000 - $100,000 liability for property damage. Amount on this (these) car(s):
Name of Insurance Company*
Policy #*
Liability ($)*
Property Damage ($)*
Medical ($)
Uninsured Motorist
Insurance Card Expiration Date*

MonthDayYear
Date
Upload your Insurance Card*

Click to upload
Maximum upload size: 10MB Cancelof
Upload Insurance Declaration Page of Insurance*

Click to upload
Maximum upload size: 10MB Cancelof
Additional Information
Are you licensed to drive a commercial vehicle?*

YesNo
Have you been in an accident in the last three years? If you answered YES, please describe the accident and its cause.*

YesNo
Please describe*
Have you been ticketed for moving violations within the last three years? If you answered YES please describe the infractions.*

YesNo
Please describe*
Have you been convicted for DWI/DUI of alcohol or drugs, or had your license suspended for moving violations. hit and run, eluding an officer, reckless or negligent operation of a vehicle, or driving while under suspension or revocation?*

YesNo
[Note: Our school will not be able to use volunteers with a "yes" answer even if the incident took place before the person became a Christian.)
Have you ever been convicted of a misdemeanor involving children or any felony? If YES, Please describe.*

YesNo
Please describe*
Authorization Information
I affirm that I will carefully transport students under my care, including obeying all traffic laws. The information given on this form is true and correct to the best of my knowledge.
Signature*

Clear
Pacific Point Schools | 1575A Mantelli Dr., Gilroy, CA 95020 | (408) 847-7922
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VOLUNTEER DRIVER APPLICATION FORM

Volunteer Driver Information

Vehicle Information

Additional Information

Authorization Information