Driver Certification Request

Requester:
(First Last)
Department:
E-mail :
Phone :

Please Certify Drivers Below:

Full Name:
(Last, First MI)
License #:
State:
Affiliation:

Driver 2

Full Name:
(Last, First MI)
License #:
State:
Affiliation:

Driver 3

Full Name:
(Last, First MI)
License #:
State:
Affiliation:
 
Indicate how certification card(s) will be handled:
Campus Mail
Will Pick Up
     (notified by e-mail)
Comments:

   

Instructions:

  • If your department is not listed, select "Other" and list your department in comments area.

  • Search Driver Database for current certification before submitting request.

  • Request form must be submitted by authorized department personnel.

  • Form must be filled out completely and accurately.

  • Request takes two weeks to process, certification cards or a letter of denial will be campus mailed to requesting department.

  • Van Training required for driving vans on university business. Call Environmental Health and Safety at 541-346-3192 for details.

  • Use "Comments" area for purchase order info or additional drivers. If listing additional drivers, please provide required information.

   
Driver Certification Request


Department of Public Safety

1319 East 15th Avenue
Eugene, OR  97403
Ph: 541.346.5444  Fax: 541.346.0947

University of Oregon

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