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CONTRACT OR VOLUNTEER DRIVER APPLICATION I, residing at (print name) (print address) do hereby apply for consideration as a Contract Driver Volunteer Driver Both contract and volunteer driver, and do hereby authorize the City of Hoover, the Parks and Recreation Department/Board, and the Hoover Library Department/Board to conduct an examination of my motor vehicle records for the purpose of confirming the information contained on this application and/or obtaining other information which may be material to my qualifications as a Contract or Volunteer Driver. I release the City of Hoover and/or its boards, agents and any person or entity, which provides information pursuant to this authorization, from any and all liabilities, claims or law suits in regard to the information obtained from any and all of the above referenced sources used. If this examination reveals no unsafe driving practices, I understand I will be placed on a list of approved Contract Drivers. If utilized for this purpose, I will adhere to the all rules and regulations given me by the City and/or applicable Board, as well as any applicable driving laws. I further understand that the city does not provide for any medical insurance coverage for me as a contract or volunteer driver. However, the city does provide automobile liability insurance coverage as an approved operator of a city vehicle. I further agree to indemnify and hold harmless the City of Hoover, the Parks and Recreation Board, the Hoover Library Board and the respective officials, agents, servants, representatives, volunteers, employees and board members from any and all claims for injuries or damages, which I incur to myself, arising out of, connected with, or in any way associated with the activities of driving for the city. Date of Birth Alabama Driver License # Social Security # How many years have you held your Alabama Drivers License? If you do not currently have an Alabama Drivers License, you must obtain one before you can qualify as a Contract Driver. If less than 3 years, list any other states you held Drivers Licenses: State(s) Other Drivers License Number(s) Home Phone Number Cell Phone Number Date Signature of Applicant Date Signature of Applicable Dept Director Title or Volunteer Driver Application Form Rev 04_01_2008.doc