DriverCertificationFormandSafetyAgreement(Formdoc.docVIP

11/22/10 Vehicle Driver Certification and Safety Agreement Section G-Form 27 pg 1 of 2 Driver Certification and Safety Agreement Name  FORMTEXT
????? Safe driving is a number one priority and driver negligence is not allowable. As part of the NWSA driver screening procedure, you must agree to the following: I will not use or possess alcohol or illegal drugs while driving ESD/NWSA/Sponsor vehicles or personal vehicles for work purposes. Alcohol may never be transported or stored in a ESD/NWSA/Sponsor vehicle. I will not drive ESD/NWSA/Sponsor vehicles or personal vehicles for work purposes if I have been under the influence of alcohol or drugs within the past eight hours. I possess a valid (current) drivers’ license I have submitted my Driving Abstract I am 21 years or older if I am transporting passengers for work purposes. I meet all other requirements on the reverse of this document. I have reported any and all information that may not have appeared in my Driving Abstract or Criminal Record and might be related to my eligibility to drive ESD/NWSA/Sponsor vehicles or my personal vehicle for work purposes. I will immediately report any accidents, traffic violations, arrests, or criminal offenses to the Director or Coordinator of the program with which I am enrolled. I will not use a cell phone while operating ESD/NWSA/Sponsor vehicles or my personal vehicle for work purposes. I will abide by all the NWSA driving safety rules, procedures, and expectations. Signature  FORMTEXT
????? Date  FORMTEXT
????? NWSA ADMINISTRATIVE REVIEW The following certifies the above named driver has fulfilled the following:  FORMCHECKBOX
Valid Driver’s License  FORMCHECKBOX
Driving Abstract Reviewed and Acceptable Additional requirements for driving ESD/NWSA/Sponsor Vehicle:  FORMCHECKBOX
Passed Driving Practicum  FORMCHECKBOX
 Attended Vehicle Orientation  FORMCHECKBOX
 Passed Winter Driving Practicum (MAC only)  FORMCHECKBOX
 Passed Trailer Pra