HM Drivers Application "*" indicates required fields Personal InformationName* First Last Date of Birth* MM slash DD slash YYYY Email* Address* Street Address Address Line 2 City ZIP / Postal Code Phone*Select One* Staff Member Church Member None of the above If so, for how long? Licensing InformationName On License* License Type* OPERATOR CHAUFFEUR NOTICE: CHAFFEUR licenses require an updated medical examiner’s certificate copy attached.License number* EXPIRY DATE* MM slash DD slash YYYY Note any Restrictions In what other state(s) have you had a driver’s license in the last ten years?Have you had any moving traffic violations, arrests, or convictions in the last five years?* Yes No If YES, please note the violation(s) and date(s): Have you ever been denied a driver’s license, or had it revoked or suspended?* Yes No If YES, please note the circumstances and date: Do you have medical insurance? Yes No If so, who is your current provider?CALVOSMOYLAN’SSTAYWELLTAKECARETRICARETRIWESTOther Insurance Provider Policy Number I agree to abide by all church regulation regarding volunteer drivers and I agree to advise the church immediately of any changes in the information above.* YESMinistry Vehicle Usage Policy* I agree with the policy.Ministry Vehicle Usage Policy The following policy and procedures have been established in an effort to provide consistency in the management of our vehicles or vehicles used and owned by volunteers. These guidelines must be followed to avoid damage, injury, or abuse to the vehicles, facility and/or its users. The purpose of Ministry Vehicle Usage Policy is to establish a fair process for the allocation of the church’s owned and/or leased vehicles to as many staff as possible and to monitor the use of vehicles used and owned by volunteers for church related activities. The Ministry Vehicle Usage Policy Administrator is Cliff S. Paulin and his extension no. is _266_ . Use of church owned or leased vehicles for personal purposes is prohibited (unless a church owned/leased vehicle has been assigned to you for personal and business use). Drivers must have the appropriate GovGuam required class of license for the vehicle operated. Requests for vehicles will be honored on a first-come, first-served basis. When scheduling conflicts arise, the Administrator may use his discretion to ensure that no group or individual monopolizes the use of the vehicles and resolves the conflict in schedules. Only licensed drivers who have submitted the Volunteer/Church Driver Application and have been approved by the Policy Administrator may drive any vehicle for church business-use. Drivers must drive responsibly at all times and follow all local traffic regulations, including the speed limit. Vans and buses are particularly susceptible to rollover if sharp turns are made at excessive speeds. When possible, vehicles request should be scheduled 24 hours prior to the actual date of intended use. We recommend as many days’ notice as possible to insure reservation of the vehicle. It is required that approved drivers must sign out the key and fill-out the log sheet from the front desk on the day of their scheduled use of church owned vehicle(s). The School (front) office is open M-F from 7:30am-4:30pm. Keys must be signed out during this time. If vehicle(s) are to be used after hours, weekends or holidays, then the keys can be checked out ahead of time once vehicle is available during normal business hours. The keys to all owned/leased vehicles must be turned in after each use at the School (front) office. The log sheet is monitored and kept for recording each use and availability. Approved drivers may not keep copies of the vehicle keys in their possession. ALL keys must be returned to the School Office immediately upon return. The approved driver should note the fuel levels and return the vehicle with at least ½ tank of gas, in case of an emergency, when the fuel level is below ½ tank, the driver should refuel and turn in the receipt for re-imbursement. Gas and repair reimbursement is subject to the church’s standard expense reimbursement policy. It is the driver’s responsibility to notify the School (front) office of the vehicle(s) fuel level upon returning. If there are any problems, the Administrator should be advised before the vehicle is used. Upon returning the vehicle, please remove ALL trash and belongings from the interior of the vehicle. Eating is prohibited at all times in any of the vans. This will help keep the vehicles free from any unwanted pests (i.e. ants, roaches). Report any maintenance needs and/or accidents/damage immediately to the Facilities Director. (For all traffic accidents – please contact the police and obtain a police report – these must be turned in to the Administrator as soon as possible). Note: Car Insurance and Registration information is in the vehicle, and will need to be provided in the event of an accident. Young children must ride in child safety seats as required by local/federal regulations. All passengers must be always seated and in their seat belts at all times while vehicle is moving. There may not be more passengers in any vehicle than the number of seatbelts in the vehicle. For example, if there are 5 seatbelts, there should only be 5 passengers. Drivers may not answer or talk on their cell phones while operating the church vehicle(s). The Church reserves the right to remove any driver from the approved driver list. Please treat each Church’s vehicles with respect while using them and return them in a clean condition. Please be considerate to other groups, ministries or staff who will be using the vehicles. God has blessed us tremendously with these vehicles and we are called to be good stewards over everything He has given us. Therefore, everyone’s cooperation is needed to keep this valuable resource in good shape for many years to come. Please upload your Drivers liscesne and any other supporting doucments* Drop files here or Select files Max. file size: 20 MB.