EEBB-R(2) Use of Private Vehicles for School Business: Staff Permission Form

Use of Private Vehicles for School Business: Staff Permission Form
The Board allows staff to use private vehicles for school purposes to conduct school business and to transport students to school sponsored activities. This form must be completed and on file in the Superintendent's office prior to employees transporting students under this policy.
Please complete the following form:
Name of Employee: _________________________________________________________________
Driver's license number: ___________________________________, valid until: _________________
Do you affirm that you carry a minimum liability insurance of $100,000/$300,000; minimum property damage insurance of $50,000; and a minimum medical coverage of $5,000? Yes____ No____
Do you have insurance against unlicensed motorists?:______________________________________
Do you affirm that your vehicle has a current legal inspection sticker and is currently registered in the state of Maine?
Do you affirm that you have seat belts for all occupants that will be riding in your car and affirm that you will insist that seat belts are worn at all times the vehicle is moving?

Signature of staff member					Date
Approval is given for this staff member to use private vehicle after meeting the above requirements for student/staff transport for sanctioned school events or activities.

Superintendent						 Date
Revised: March 25, 2024