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Driver Insurance Verification Form

The completion of this form is required if you intend to drive students, other than your own, for school sponsored field trips, events or after-school sports. Required fields marked with an asterisk *

CONTACT INFORMATION OF THE DRIVER

First Name*

Answer Required

Last Name*

Answer Required

Email of Driver*

Answer Required

Mobile Phone Number of Driver*

Number Required

Driver's Driver's License Number*

Answer Required

DRIVER'S AUTO DESCRIPTION

Car Make*

Mercedes, Chevrolet, Hyundai, etc.

Answer Required

Car Model*

Sprinter, Suburban, Palisade, etc.

Answer Required

Car Year*

Answer Required

DRIVER'S AUTO INSURANCE INFORMATION

Name of Auto Insurance Carrier*

Answer Required

Auto Insurance Company Contact Phone Number*

Number Required

Auto Insurance Policy Number*

Answer Required

Auto Insurance Policy Expiration*

Answer Required

Driver's Automobile Liability Insurance Limit Amount ($)*

Please enter dollar amount

Answer Required

Auto Insurance Medical Payment Coverage Limit ($)*

Please enter dollar amount

Answer Required

Please upload a photocopy of the driver's valid Driver's License*

Answer Required

Choose a file or drag it here.

Please upload a photocopy of the driver's valid Auto Insurance Card*

Answer Required

Choose a file or drag it here.

For school sponsored events, the diocese requires all volunteers, including drivers, to follow all volunteer guidelines. Volunteers are required to:

Be fingerprinted through the diocese
Successfully complete Safe Environment Training
Either be fully vaccinated for COVID-19 or show proof of negative test within 72 hours of volunteering

All drivers who will be transporting students must also successfully complete an online safe driving course. The course is through CMGConnect, the same program used for the Safe Environment training.

Click Here for online training instructions to register or sign in if you already have an account.

Confirmation Email

Email Required