Revised,April2016
Page1of1
University of Guelph
Faculty & Staff Driver Profile Information
For Transportation Services
Faculty/Staff Name ____
________________________________________ Date _________________
(Please Print)
Department _____________________________________________ Extension __________________
University Employee Number ___________________________________ License Class ___________
Ontario Driver’s License Number ____________________________________ Expiry Date ____________
Supervisor’s Name & Title _____________________________________________________________
(Please Print)
Full-time Driver Yes
Temporary Driver Yes
Start Date____________________ End Date __________________
Complete this Section Only of you p
ossess a Class “A” License
Date of Last Medical ________________________ Last Abstract Date _________________________
To be filled out by
the Driver:
I certify the above information to be accurate. I am aware of and will conform with the University of Guelph’s
policy and the procedures on the use of University owned, leased and rented vehicles as specified in University of
Guelph policy 1.2.25 – Licensed Vehicles.
Signature _____________________________________________ Date _______________________________
Statement by
Department Chair/Director/Manager/Supervisor:
I appr
ove the use of the University vehicle Make:__________ Model:___________________ U of G ID No.:_________
Signature _____________________________________________ Date _______________________________
This form is to be printed, signed and emailed to the Manager, Transportation Services, Physical Resources
at vehicle@pr.uoguelph.ca
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome