Imlay City Schools Van Driver Form
Driver Name
First Name
Middle Name
Last Name
Suffix
Driver Email
example@example.com
Driver Cell Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Driver Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please upload a copy of your current driver's license:
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IMPORTANT
Only authorized driver(s) are allowed to drive the requested vehicle. Driver's license information must be complete and accurate prior to approval. I understand that the vehicle will be returned clean or I will be charged for cleaning. I, the undersigned, take full responsibility that the information provided is accurate and I will be the only driver.I hereby give the Director of Transportation permission to run my personal driving record. My driving record will be securely kept in the transportation office.
Signature
Should be Empty: