Driver Certification Request Form

Smart Form Standard Web Part 2

First Name *

Last Name *

Affiliation *

DePaul Email Address *

Supervisor

Supervisor's Email

Department/Program (what will you be driving for?) *

I have held a valid state-issued and/or international driver’s license(s) for a minimum of two years. *

What state/country is your license from? *

Will you drive a Full-Size Van? Check the box below if yes. *

Will you transport minor children (anyone under 18 who is NOT a DePaul student/employee/registered patron of the Ray)? Check the box below if yes. *