Driver Data Form (Confidential)
Personal Data
Name ________________________________________
Address _____________________________________
_____________________________________________
Home phone (_____) ___________________________
Emergency phone (_____) _______________________
Additional Personal Data
Number children in district:
_______ Now _______ Past _______ Grandchildren
List family members employed by the Board
(Name, position, & location):
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
List organizations of which you are a member:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
List relatives or friends who are community leaders
(political/business/civic)
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
100 – AR Handbook
List any talents/hobbies/special abilities:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Work Data:
District resident? Yes No
Total yrs. driving bus: _________ for district: ________
Number of accumulated sick days _________________
Years in pension plan ___________________________
Emergency response availability:
10 min. 20 min. 30 min.
Hours worked/day: _____ / _____ Hourly rate _______
Package hours: 2 4 5 6 8
Rt. # ________________________________________
Packages : Elementary Middle High
Vocational Shuttle Spec. Ed
Other ________________________________________
Time: start ________ (am/pm): end ________ (am/pm)
Actual driving time (include layovers): ______________
Actual working hours per week: __________________
Average hours/month for Emergency/OT: __________
Assigned pupils per package:
_____ Elementary _____ Middle _____ High
_____ Vocational _____ Shuttle _____ Spec. Ed
Other ________________________________________
Summer work hrs. _________ Amt. paid ___________
Extra runs daily: (i.e. Kindergarten/late) ____________
# of Students _________ Amt. Paid ________________
Check here if using another sheet for additional
information that you feel is pertinent.