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Driver Application Form

Work Experience

Number of moving Violations (Past 3 Years)

Number of preventable Accidents (Past 3 Years)

Have you ever been convicted of, or are charges currently pending for any of the following:

*a Felony?

*a Misdemeanor?

*a DUI, DWI, or any other Alcohol Related Offense?

*Reckless Driving?

*Possession, Sale, Or use of Drugs

*Have you ever tested positive for drugs or alcohol or refused a drug or alcohol test?

*Has your license ever been suspended?