2021-2022 Driver Authorization Form
All adults who volunteer to drive on school trips must complete and sign this form prior to transporting any Stanbridge Academy students by vehicle to or from a school function. In addition to completing this form, you will be asked to provide a copy of your driver's license and auto insurance card for our files in the main office.

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Email *
Driver's Full Name *
Driver's cell phone number (in case of emergency) *
Student's Full Name *
Driver's relationship to student *
Driver's License Number *
Driver's License State *
Driver's Date of Birth *
MM
/
DD
/
YYYY
Name of auto insurance provider *
Auto insurance policy number *
Please answer the following questions (In order to be a Parent Driver, you must answer "no" to questions 1 and 2, and "yes" to questions 3 and 4). *
Yes
No
Have you had more than 2 tickets in the last three years?
Have you ever been arrested on a DUI (driving under the influence)?
Do you carry at least $300,000 liability coverage?
Do you give us permission to verify your driving record?
Vehicle make and model *
Number of available seats for passengers in your vehicle (Note: Seats must include a functioning safety belt. By law, front seat passengers must be older than 8 years and taller than 4'9"). *
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