LCS Application for Volunteer Driver

DRIVER'S CONTACT INFORMATION

I am a: (choose as many as apply) *
 

DRIVER'S INFORMATION

Applications may be approved only when the driver possesses a valid, appropriate driver’s license and is able to respond No to questions concerning convictions and suspensions over the last three years.

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Has your driver's license been suspended in the last three years? *
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Have you been convicted of an offence under the Highway Traffic Act, or for any motor vehicle-related offence under the Criminal Code of Canada during the last three years? *
Vehicle Information
 Vehicle 1Vehicle 2
Year/Make/Model
Colour
License Plate
Passenger Capacity (incl. driver)
Owner's Name
Owner's Address
Owner's Phone: Home/Work/Cell

COMMITMENTS:

By submitting this application to become a volunteer driver for Langley Christian School:

  1. I undertake to ensure that the vehicle used to transport students is in safe operating condition.
  2. I agree
    - To operate the automobile referred to herein in a safe manner.
    - To abide by all applicable laws at all times while I am transporting students
    - To limit the number of passengers to the number of useable seat belts
    - To require proper use of occupant restraint systems (i.e. seatbelts, head restraints airbags, set position), and
    - To comply with the directions of teachers or agents of Langley Christian School
  1. I undertake to report to the school principal all accidents and any suspension of my license or change in my insurance status which may occur after the date of this authorization while it remains in force.

  2. I accept the foregoing undertakings and certify that the information contained in this application is correct to the best of my knowledge.
Signature of Driver: *
clear
Signature of Owner:
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clear
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FOR OFFICE USE ONLY

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