Vehicle Operator Approval Request Form

Please fill out this form to request approval for driving campus vehicles. This is a two step process:

1. Fill out the form below with assistance from your Department Vehicle Coordinator. Upon Submission of this form, you will be redirected to an additional secure website to submit your information for a driving record background check.
2. Follow the secure link that you are redirected to and submit your driver’s license information for a background check.

By submitting the form below, you are agreeing to the following statements:

I am aware that a driver license record (MVR) check will be obtained as part of Mines evaluation to drive a fleet vehicle, my job application or employment. The records may be procured by Mines or its insurance company representative(s), and may include personal information obtained from the appropriate agency. My driving record will be used as an assessment of my qualification as an approved vehicle operator.
By signing this form, I have read and understand the Mines Fleet policy and hereby provide my authorization for Mines or their insurance company representative(s) to procure such information and reports, as well as additional reports on an annual basis as deemed appropriate, to evaluate my continued approved driver status.