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Motor Pool  - Driver Registration Form

(This form is for Maryland drivers only. All other drivers have to go to their own state's DMV or MVA to get driving records. Please fill out and submit to the Motor Pool Office).

Full Name: (please print)

First: Middle: Last:
Driver's License Number:  
Date of Birth:
State Issuing License:  S.U. ID Number:

I agree to allow the Fleet Manager of Salisbury University to obtain a copy of my driving record from the state of Maryland Motor Vehicle Administration now and on an annual basis. I also agree to notify the fleet manager if my driving record accumulates six or more points for moving violations.


_________________________________________________________
Signature and Date


_________________________________________________________
Department for Which You are Driving


_________________________________________________________
Manager or Supervisor

 

      _____ Check here if you are currently a student of SU.

      _____ Check here if you are currently an employee of SU, but not a student.

 

 

Date printed: 7/3/2015 1:22:49 PM