Application for School Bus Driver

APPLICATION FOR SCHOOL BUS DRIVER

Pike County School System

316 South Mayo Trail

Pikeville, KY 41501-1522

Name: ______

Address: ______, City ______, State ______Zip Code: ______

Telephone No.: ______Social Security No.:______

Driver’s License No.: ______CDL License with (P) Endorsement: _____Yes _____No

Name of school in which you desire a position as a bus driver: ______

If hired as a bus driver, will you make all reports willingly, neatly, accurately and promptly? ______

Will you abide by all laws, rules and regulations pertaining to the transportation of pupils? ______

Will you furnish to this office, on proper report forms, a statement as to your physical fitness, the

medical examination being at your expense? ______Will you clean your bus daily? ______

Will you check the oil, fuel, water, battery, tires, lights, windshield wipers and doors daily? ______Keep

windows and doors closed at night and when bus is not in use ______start your engine at least once on

weekends and during vacations and start it at least once the day before school resumes ______

Previous Employment: ______Previous Employer:______

Address of previous employer: ______

If self-employed, what do you do? ______In case of an emergency, who should

we contact? ______Address: ______Phone No.: ______

Will you smoke yourself, or permit students to smoke while on the bus? Yes _____ No _____

Have you ever had a serious accident? _____Who was at fault? You ______The other driver ______

Was anyone seriously injured? ______Were there any extensive property damages? ______

Have you ever had your license revoked? ______Have you ever been found guilty of traffic

violations? ______Have you ever been convicted of a felony? ______

List three (3) references, two (2) not related to you:

Name: ______Address: ______

The Superintendent has the right to screen, do a background check and reject any or all applications.

Signature: ______Date ______

The Pike County Schools does not discriminate on the basis of age, race, color, national origin, sex, religion, marital status, or disability in its educational programs, services, activities, or employment..