Driver Application - Freeport Community Services

Volunteer Driver Application

Please fill in and submit the form below, or you can download the pdf and return it to Marie by email or by post to:
Marie O'Donnell
Freeport Community Services
PO Box 119
Freeport, ME 04032

All applicants must be at least 18 years of age.

Date*

Birthday*

Name*

Legal First Name

Legal Last Name

Middle initial, if any

Previous Name

Address

Street Address City State Postal / Zip Code

Preferred Phone Number*

Alternate Phone Number

Email address*

Emergency Contact Name*

Emergency Contact Phone Number*

Emergency Contact Relationship

Skills: Please list relevant skills, work experience, interests and/or volunteer service.

Languages spoken other than English:

Have you done volunteer driving in the past? *

Yes

Are you willing to transport multiple riders at a time?*

Yes

If yes, what is the rider capacity of your vehicle?

Do you require any physical accommodations for your volunteer assignment?*

Yes

If yes, please explain.

Have you ever been convicted of any crimes not annulled or expunged by a court?*

Yes

If yes, please describe in full.

Please provide two non-family references whom we can contact regarding your potential volunteer service with FCS:

Name of Reference*

First

Last

Email*

Relationship:*

Name of Reference(2)*

First

Last

Email:*

Relationship:(2)*

Background Checks: By submitting your application to become a driver, you are agreeing to FCS completing background checks on all volunteer drivers including criminal, sex offender and motor vehicle reports.

Safety and comfort are important to the FCS Transportation Program. You will be expected to maintain a safe vehicle that is up to date with inspection, registration, and insurance*. You will be asked to provide annual documentation to support these requirements.

*Proof of insurance shall meet the following minimum insurance requirements: $50,000 for bodily injury per person, $100,000 bodily injury per accident, $25,000 for property damage and $50,000/$100,000 Uninsured/Underinsured motorist) to be kept on file at FCS. A volunteer may not accept trip requests until all documentation is on file.

Please accept these terms:*

Date:*

I attest that the above information is true to the best of my knowledge. Name accepted as digital signature:*

To complete your application, please upload:

Copy of your Driver’s License

Proof of Auto Insurance

Copy of Registration on all vehicles you will use in providing rides

Upload drivers license:

Upload proof of auto insurance:

Upload registration:

Uploads are transmitted with SSL encryption, and stored securely on our server.

The following file types are accepted: jpg, jpeg, png, pdf, doc. Each uploaded file cannot exceed 5 MB.

If you experience problems uploading your documents, or have any questions, please contact Marie O'Donnell, AFFP Coordinator at modonnell@fcsmaine.org or (207) 865-3985 ext. 222.