LifeWise Vehicle Driver Screening

Initial Question

Will you be driving LifeWise Students?

Any driver who will be transporting LifeWise students more than once must apply as a LifeWise driver and complete the onboarding process.

This form should be used ONLY by drivers who will be borrowing a LifeWise vehicle, not by drivers who will be transporting LifeWise students. Any driver who will be transporting LifeWise students must apply as a LifeWise driver and complete a background check and necessary training.

Driver Information

First Name

Last Name

Date of Birth

LifeWise Program from which the Vehicle will be Borrowed

Driver's License State

Driver's License Number

Driver's License Expiration Date

Driver's License Type

Endorsement

PSOtherNoneSelect all that apply

Driver Screening Questions

Do you have an active LifeWise Background Check?

Have you been at fault for any accidents?

Have you had any moving traffic violations?

Have yours or any insurance company cancel or refuse to provide you with auto insurance?

Have you had your driver's license revoked, suspended, or restricted?

Do you have any physical impairments that will hamper your ability to drive students to and from LifeWise classes?

Have you ever been charged or convicted of "driving while intoxicated" or "driving under the influence"?

Due to answering YES to this question, we ask that you formally apply for a Driver Applicant Position and go through the necessary steps required. Please contact your Program Director for further steps.
Thank you.

Due to answering NO to this question, we ask that you formally apply for a Driver Applicant Position and go through the necessary steps required. Please contact your Program Director for further steps.
Thank you.

Program ID