Fillable Driver Eligibility Form (Eastern Florida State College)

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Driver Eligibility Form (Eastern Florida State College)

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File type: PDF

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DRIVER ELIGIBILITY REQUEST FORM
Important: ONLY College Employees are authorized to drive college vehicles
Driver’s Name:
B#:
Department/Campus
Office Phone
Cell Phone:
Driver’s License #
I authorize Eastern Florida State College to conduct an inquiry of my driving history and eligibility.
Signature
Date
*** PLEASE ATTACH A COPY OF DRIVER’S LICENSE ***
Full-time Staff or Faculty
Part-time Staff
Adjunct
Department Affiliation
Driver’s Supervisor
Reason for Request
Future Need
Scheduled Trip (Complete below if selected)
Trip Destination
Purpose of Trip
Trip Dates
From:
To:
Number of Passengers
(No more than 15 passengers w/o CDL/Passenger Endorsement)
This form entitles the individual to be placed on the EFSC Driver Eligibility List. Separate authorization
is needed to operate a college vehicle.
Return form to Human Resources, attention Sarah Poff - Building 2, Room 114 Cocoa
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Driver Eligibility Form (Eastern Florida State College)

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Completed 23 July 2020

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