Approved Driver Request Form

Transcription

1 Approved Driver Request Form This form is used to: request approval to drive team members and/or coaches on official club travel, submit updated driver's license and/or automobile insurance information, be removed from the club sports DMV pull system. This form must be submitted by the applicant - it can't be submitted on behalf of someone else! This form is not for paid coaches. Approval to drive is needed regardless of the type of vehicle used (personal or rental). New drivers- submission of this form will require you to: agree to a variety of terms and conditions upload a legible photo or scan of the front side of your valid driver's license upload a legible photo or scan of the front side of your valid automobile insurance card upload a completed scan of the required DMV form (link provided in this application) successfully complete a brief quiz regarding the policies and procedures outlined in this application. Upon review of your submission, we will submit your information to the California DMV to request a report of your driving record (this applies to all applicants regardless of the state that issued their drivers license. Additionally, we will enter you into a "pull notification system", which will alert us of any future activity on your driving record. You will remain in the pull notification system until you either request to be removed from the system (and at that time will no longer be an approved driver). For applicants who have a California driver's license, we typically receive your driving record within three business days. For applicants who posses a license issued by another state, we typically receive your driving record within eight weeks (don't worry, there may be an option for you to be approved sooner - option is explained in the application!) All new drivers are required to complete an online driver training course. Once you complete this form, an will be sent out with this information. Once your application is approved, you are eligible to begin driving. You will receive an OrgSync notification indicating your submission has been approved, and you will be added to the Approved Driver List, which can be found under the people tab on the left side navigation. If you have any questions regarding the process, feel free to contact Megan Normansell at mnormansell@recreation.ucla.edu Type of Request Why are you submitting this form? [Required] [ ] To become a new driver [ ] I was an approved driver last year [ ] To request to be removed from the DMV system [ ] Minimum Requirements The following are minimum requirements that must be met to become and to remain an approved club sports driver: May not have a DUI, reckless driving, or other convictions that have led to a license suspension or revocation. May not have any physical impairment that impacts your ability to drive. Must be at least 18 years of age. Must have at least the minimum automobile insurance requirements required by the State of California. Must have a valid driver's license from one of the 50 states. Terms and Conditions Checkbox [Required] I certify that I meet all of the minimum requirements listed above and understand that if for any reason I no longer meet one or more of the minimum requirements listed above, it is my responsibility to notify a member of the club sports staff. [ ] I Certify General Travel Policies The following general travel policies apply to all approved club sports drivers: A driver may not drive for more than three (3) consecutive hours or drive more than six (6)total hours per day. After driving for three (3) consecutive hours, a minimum break of 15 minutes is required. Travel is only allowed between the hours of 5 am and Midnight (Commercial travel excluded). Automobile travel is limited to 600 miles or 10 hours within a 24 hour time frame (between the hours of 5 am and Midnight.) Page 1 of 8 Approved Driver Request Form

2 General Travel Policies [Required] I understand that any approved club sports driver who violates one or more of the general travel policies listed above may be subject to disciplinary action that may include loss of approved driver status, suspension from club activities and competitions, and/or referral to the Office of the Dean of Students for further review. and Agree to Abide by All Policies Specific Driver Policies The following Driver Policies apply to all approved club sports drivers while traveling on official club business. Must have your valid driver's license in your possession while driving. Must drive safely and obey all state and local laws/ordinances. Must wear a seat belt at all times; must ensure passengers are wearing seat belts at all times. Must follow rules for vehicle use. Must refrain from consuming alcohol and/or illegal substances; refrain from prescriptions or over-the-counter drugs which may cause drowsiness (check the label or ask pharmacist). Must refrain from distracting behaviors while driving (e.g. eating, smoking, adjusting radio controls, etc.) Cell phones must not be used while driving even if used with a hands-free device, unless it is an emergency situation. Must only transport individuals who are on University business (no family members, hitchhikers or friends). Must check the vehicle prior to driving to ensure it is fully operational and safe to drive. Must not operate vehicle if any of the following are not operating properly: engine, transmission, brakes, tires, lights, steering. Must not operate in extreme weather including: rain, snow, ice or fog. Agreement Terms [Required] I understand that any approved club sports driver who violates one or more of the driver policies listed above (while traveling on official club business) may be subject to disciplinary action that may include loss of approved driver status, suspension from club activities and competitions, and/or referral to the Office of the Dean of Students for further review. Driver Agreement Understanding Please read through each of the terms listed below. If you understand a term, please click "I Understand". If you do not understand a term, please contact the Clubhouse at (310) Personal Responsibility [Required] I understand that I am personally responsible for any traffic citations that I may receive and that the University/Club will not pay for or reimburse for such costs. Auto Insurance [Required] I understand that I am required to maintain continuous automobile insurance coverage, and provide proof of insurance to the Club Sports staff. Accident Reporting [Required] I understand that I must report any accident that I am involved in within 48 hours (complete a vehicle accident report.) Page 2 of 8 Approved Driver Request Form

3 Driver's License [Required] I understand that if my driver's license is suspended, is no longer valid, or if I am cited for DUI, I agree to notify a club sports staff member immediately and indicate that I am no longer eligible to drive. I understand that if I fail to notify a club sports staff member of a suspended license or DUI citation, and I drive a rental, University or personal vehicle (with club members), on behalf of myself, my heirs, executors, administrators, insurers, and assigns, I agree to defend, idemnify, and hold the Regents of the University of California harmless from any and all injuries to me, including death, that occur while I am driving. Failure to notify a club sports staff member of a suspended driver's license or DUI citation may also lead to further disciplinary (including review by the Office of the Dean of Students.) Moving Citations and Supplemental Discipline [Required] I understand that any violation of policy or law that may occur while traveling may be subject to review by the Office of the Dean of Students and may be subject to disciplinary actions. Driver Authority The driver is responsible for the safe operation of a vehicle and therefore has the authority to enforce all policies and to ask for compliance from all passengers. Driver is empowered to discontinue trip until all problems are resolved. Terms and Conditions Checkbox [Required] I understand the responsibility and the authority that I have as an approved club sports driver. Approved Driver Status I understand that I may not drive on official club business until my form/application has been approved. I will know this form/application has been approved when I receive an Orgsync message indicating my form/application has been approved (you can also check the status under My Submissions.) I understand that if I driver prior to receiving approval, I am violating club sports policy, as well as the UCLA Student Code of Conduct, and violation will result in appropriate disciplinary actions. Terms and Conditions Checkbox [Required] I understand that I may not drive on official club business until this form has been approved. General Information What State's drivers license do you hold? [Required] [ ] California [ ] Other US State What date does your driver's license expire? (submit copy of license below) [Required] What date does your car insurance expire? (submit copy of insurance below) [Required] UCLA ID Number: [Required] Page 3 of 8 Approved Driver Request Form

4 What club are you requesting to drive for? [Required] [ ] Archery [ ] Badminton [ ] Baseball [ ] Men's Basketball [ ] Women's Basketball [ ] Boxing [ ] Brazilian Jiu-Jitsu [ ] Climbing [ ] Cycling [ ] Dragon Boat [ ] Equestrian [ ] Gymnastics [ ] Fencing [ ] Figure Skating [ ] Golf [ ] Ice Hockey [ ] Jeet Kune Do [ ] Judo [ ] Kendo [ ] Kung Fu [ ] Lacrosse, Men's [ ] Lacrosse, Women's [ ] Powerlifting [ ] Quidditch [ ] Rowing, Men's [ ] Rugby, Men's [ ] Sand Volleyball [ ] Rugby, Women's [ ] Running [ ] Sailing [ ] Shinkendo [ ] Ski and Snowboard [ ] Softball [ ] Soccer, Men's [ ] Soccer, Women's [ ] Swim [ ] Table Tennis [ ] Taekwondo [ ] Tennis [ ] Triathlon [ ] Ultimate, Men's [ ] Ultimate, Women's [ ] Volleyball, Men's [ ] Volleyball, Women's [ ] Water Polo, Men's [ ] Water Ski [ ] Waterpolo, Women's [ ] Wrestling [ ] Track and Field [ ] Wushu Status [Required] [ ] Club Sports Participant - UCLA Student [ ] Club Sports Participant - Recreation Member [ ] Club Sports Volunteer Coach [ ] *Other (describe below) Status - Other If you selected Other as your status, what is your status? [Required] Applicant Information - Other State Although we have the ability to check driver's records from all 50 states, the time that it takes to check the record of a driver from a state other than California is significantly longer because we must submit paperwork directly to the California DMV and wait for them to request the driver's record from Page 4 of 8 Approved Driver Request Form

5 the driver's home state - the process typically takes 8 weeks. Since a driver can't be approved to drive until we have reviewed his or her driver's record, a driver can either wait the estimated 8 weeks, or request a copy of his or her driver's record directly from their home state. Please note, this application must still be submitted even if providing a copy of your driver record! To assist out of state drivers, we have provided select state's links to information regarding obtaining a driver record or abstract. Arizona Nevada Illinois Contact Information [Required] - must be digits long and may include only numbers, hyphens, and spaces. - name@myschool.edu First name: Middle initial: Last name: address: Phone number: Address: City: State: ZIP: Driver's License [Required] Upload a clear picture or scan of your driver's license. Automobile Insurance [Required] Upload a photo or scan of your automobile insurance card. What is your middle name? [Required] What State's drivers license do you hold? [Required] Driver Record or Abstract If you obtained your driver's record or abstract, you can upload it here. If you prefer, you can it to clubhouse@recreation.ucla.edu. If you do not provide an abstract, remember, you will need to wait an estimated 8 weeks before you are approved to drive. Applicant Information - California Contact Information [Required] - must be digits long and may include only numbers, hyphens, and spaces. - name@myschool.edu First name: Middle initial: Last name: address: Phone number: Address: City: State: ZIP: Driver's License [Required] Upload a clear picture or scan of your driver's license. Automobile Insurance [Required] Upload a photo or scan of your automobile insurance card. Page 5 of 8 Approved Driver Request Form

6 Driver's License Number [Required] Enter your driver's license number. If you enter the number incorrectly this will delay your application! DMV Form All applicants regardless of state must click this link to access a DMV Authorization for Release of Driver Record Information. To access the form, copy and paste this URL into a new window: When you complete the form be sure to list "UCLA Recreation" as your employer! Since the form requires your signature, you will need to print the form, complete and sign the form, and return the form to us. To expedite the review of your application, we ask that you scan the form and attach it below. You may also return the form to us: Via to clubhouse@recreation.ucla.edu Via fax - to (310) In-person to the Competitive Sports Clubhouse located in the John Wooden Center, Suite 2388 Monday-Friday between 10 am - 5 pm. DMV Form Print, complete and sign the form, then scan and upload the form here. (You may submit the form via one of the other options listed above.) Applicant Quiz - Question 1 After I submit my application, I am approved and able to begin driving. [Required] [ ] True [ ] False Applicant Quiz - Question 1 Incorrect - you will not be approved to drive until your application has been reviewed. Once approved, you will receive an Orgsync notification indicating your application has been approved and you will be added to the list of approved drivers (which is found under the people tab on the left side navigation bar). If you drive before you are approved you are jeopardizing your status within the club, the club's status as a club sport, and may be subject to disciplinary action through the Dean of Students Office. Applicant Quiz - Question 1 Correct - you will not be approved to drive until your application has been reviewed. Once approved, you will receive an Orgsync notification indicating your application has been approved and you will be added to the list of approved drivers (which is found under the people tab on the left side navigation bar). If you drive before you are approved you are jeopardizing your status within the club, the club's status as a club sport, and may be subject to disciplinary action through the Dean of Students Office. Applicant Quiz - Question 2 While driving on official club business, if you are involved in an accident, the University's self-insurance policy will cover the damages. [Required] [ ] True [ ] False Applicant Quiz - Question 2 Incorrect - The University does not provide automobile insurance to drivers, thus, the driver's personal automobile insurance would apply if an accident occurs. Applicant Quiz - Question 2 Correct- The University does not provide automobile insurance to drivers, thus, the driver's personal automobile insurance would apply if an accident occurs. Applicant Quiz - Question 3 Page 6 of 8 Approved Driver Request Form

7 While driving on official club business, I am responsible for the vehicle that I am driving, as well as the passengers in the vehicle. [Required] [ ] True [ ] False Applicant Quiz - Question 3 Correct - You are personally responsible for the vehicle you are driving and for the passengers. You have the authority to act accordingly based on weather conditions, passenger conduct, and vehicle capabilities. If at any time during travel you think you need to stop - stop until you believe it is safe to resume travel! Applicant Quiz - Question 3 Applicant Quiz - Question 4 What is the maximum number of hours and/or miles that can be driven (commercial transportation excluded)? [Required] [ ] No more than 12 hours or 800 miles per 24 hour period [ ] No more than 10 hours or 600 miles per 24 hour period [ ] No more than 8 hours or 600 miles per 24 hour period [ ] No limit, however, travel must occur between 5 am and Midnight Applicant Quiz - Question 4 Correct - the maximum number of hours and/or miles that may be driven in a 24-hour period is 600 miles or 10 hours, whichever occurs first. Keep in mind that this maximum would require a minimum of two drivers per vehicle, as any one driver can't drive more than six total hours per 24-hour period. All travel is limited to the hours of 5 am - Midnight. Applicant Quiz - Question 4 Incorrect - the maximum number of hours and/or miles that may be driven in a 24-hour period is 600 miles or 10 hours, whichever occurs first. Keep in mind that this maximum would require a minimum of two drivers per vehicle, as any one driver can't drive more than six total hours per 24-hour period. All travel is limited to the hours of 5 am - Midnight. Applicant Quiz - Question 5 If I am involved in a traffic accident or I receive a citation, I must notify a member of the club sports staff within 48 hours. [Required] [ ] True [ ] False Applicant Quiz - Question 5 Correct - if you are involved in an accident you must complete (and submit with 48 hours) either a University vehicle accident report or a private vehicle accident report. If you receive a citation, you can simply notify a member of the club sports staff. Applicant Quiz - Question 5 Incorrect - if you are involved in an accident you must complete (and submit with 48 hours) either a University vehicle accident report or a private vehicle accident report. If you receive a citation, you can simply notify a member of the club sports staff. Removal from the Club Sports DMV System You are requesting to be removed from the club sports DMV system. Once your request is approved, you will no longer be an approved club sports driver. Contact Information [Required] - must be digits long and may include only numbers, hyphens, and spaces. - name@myschool.edu Page 7 of 8 Approved Driver Request Form

8 First name: Middle initial: Last name: address: Phone number: Address: City: State: ZIP: Removal [Required] I am requesting to be removed from the club sports DMV system. I understand that once I am removed, I am not an approved club sports driver. [ ] Remove Me! Updated Information Great, you have updated information for us! This option can only be selected if you are an approved driver, or a previously approved driver. Contact Information [Required] - must be digits long and may include only numbers, hyphens, and spaces. - name@myschool.edu First name: Middle initial: Last name: address: Phone number: Address: City: State: ZIP: Provide your updated driver's license or insurance card here. [Required] If you are providing both an updated driver's license and insurance card, please upload separate files. Provide your updated driver's license or insurance card here. Online Driver Training Course All new and returning drivers will need to complete an online driver training course. The course will provide drivers with practical safe driving tips that will be useful both for personal driving and while driving club members. The course may also provide the driver with a discount with the automobile insurance company. Generally, you will receive access to training via within a week of submitting this form. It will include instructions to complete the training as well as your log-in information. Upon completion of the course you will receive a completion certificate, which you'll need to to the Clubhouse. Once we confirm that you have completed the course, this form will be approved indicating that you approved to begin driving. If you have any questions regarding this topic, please contact Megan Normansell at mnormansell@recreation.ucla.edu Online Driver Training [Required] I understand that I will receive an with information on how I can complete the online driver training. I understand that I may not drive club sports members or coaches until I have completed the course and have been approved to drive. Page 8 of 8 Approved Driver Request Form