Immanuel's Regional Transit LLC

Driver Application

We're looking for reliable, compassionate drivers to serve our community. Please complete all required fields marked with an asterisk (*).

Personal Information

Full Legal Name *

Street Address *

City *

State *

ZIP Code *

Phone Number *

Email Address *

Date of Birth *

Driver License Information

We collect only the last 4 characters of your license number, the issuing state, expiration date, and license class. Your full license number is not requested at this stage.

License Issuing State *

Last 4 Digits of Driver's License Number *

Letters and numbers accepted. Do not enter your full license number.

License Expiration Date *

License Class *

Driving Experience

Describe Your Driving Experience *

Include years of experience, types of vehicles driven, and any relevant passenger transport or medical transport experience.

Employment History

Previous Employment *

List your most recent employers, job titles, and dates of employment.

Availability

When are you available to work? *

Passenger Experience & Capabilities

Do you have experience transporting seniors or elderly passengers? *

Do you have experience transporting people with disabilities? *

Are you able to provide door-to-door assistance for ambulatory passengers, including those who use walkers or canes? *

This includes helping passengers safely from their door to the vehicle and from the vehicle to their destination entrance, within your physical capabilities and training.

Certifications

Do you hold a current CPR certification? *

Do you hold a current First Aid certification? *

Background Disclosures

Has your driver's license ever been suspended or revoked? *

Have you ever been convicted of a felony? *

Acknowledgments

As a condition of employment consideration, all applicants must agree to the following. Please select "Yes, I agree" for each item.

Criminal Background Check *

I authorize Immanuel's Regional Transit LLC to conduct a criminal background check as part of the hiring process.

Driving Record Check *

I authorize Immanuel's Regional Transit LLC to obtain and review my driving record (MVR) as part of the hiring process.

Drug Screening *

I agree to submit to a pre-employment drug screening as a condition of employment consideration with Immanuel's Regional Transit LLC.

Electronic Acknowledgment & Signature

By typing my full name below and submitting this application, I certify that all information provided is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in disqualification from consideration or termination of employment. I acknowledge that this electronic signature constitutes my legal signature on this application.

Electronic Signature — Type Your Full Legal Name *

Date *

Your application is transmitted securely. We do not collect Social Security numbers or sensitive identity documents on this form.