Autostar Driver Application

Personal Infomation

Name

Phone

Email

Date of Birth

Current Age

Drivers License Number

Drivers License Expiration Date

Drivers License Issue State

What State was your drivers license issued ?

Current Address

Vehicle Information

Vehicle Make

Vehicle Model

Vehicle Color

Vehicle Year

Number of Seats /Seat Belts

How many seats/ seat belts does your vehicle have?

License Plate Number

License Plate Expiration Date

Auto Insurance Company Name

Auto Insuarnce Expiration Date

Application Requirement Acknowledgement

By signing this application form, I accept the following requirements of this position.

1. Driver acknowledges that all infomation provided in this application is valid. Driver is subject to background checks at any time.

2. Drivers license infomation is valid and Autostar is authorized to conduct Motor Vehicle Reports (MVR) at anytime.

3. Vehicle insurance information is valid, the Vehicle is fully insured and will remain fully insured while on any transportation assignment.

4. Driver will accept full responsibility for any injury to passengers or any damage to passengers or items while on transportation assignments.

5. Driver will obey all traffic laws and will be responsible for any traffic violations while on transportation assignments.

6. Driver acknowledges no smoking in the vehicle used for transportation assignments.

Signature