Pre-Requisite (Beginning Driver) Form

Driver Name:

ENTER THE INFORMATION OF THE DRIVER AS IT APPEARS ON THEIR DRIVERS LICENSE

Drivers License Number (Include Spaces): Example: A 123 456 789 012

Driver's Address:

City:

State:

Zip Code:

Phone Number:

SCHOOL DISTRICT/CONTRACTOR INFORMATION

School:

Address:

City:

State:

Zip Code:

Date of Class:

Location of Class:

How much will the driver get paid per hour to take the course?

Supervisor Name:

Supervisor Email Address:

By attaching my name to this form, checking the signature box, and sending, I certify that the Driver Candidate listed above has completed the standardized lessons as outlined in the Michigan Department of Education's School Bus Driver Training Program and, in my judgment, has received at least 20 hours of instruction and is prepared to enter the Beginning School Bus Driver Course.

Name of Person Submitting This Request:

Signature Check Box (required)

Phone Number for Person Submitting This Request:

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