Ministry Driver Screening

Application for CCCM Authorized Ministry Driver:

1. Please read the Brotherhood Mutual “Choosing Safe Drivers for Your Ministry.” This will give you and your administrator the guidelines Calvary Chapel Costa Mesa is abiding by for adding authorized drivers to our church auto policy.
2. Complete both the Brotherhood Mutual “Ministry Driver Screening” form, and the “Calvary Chapel Costa Mesa Driver’s Information” form below.
3. Make/Scan a copy of your current driver’s license (California, out-of-state, or international licenses).
4. For employees who are United States residents, you must obtain a copy of your driving record by contacting the Department of Motor Vehicles (DMV) in the state in which you have been issued your current driver’s license. This may also be obtained online at your issuing state’s motor vehicles website.
5. Your online application will be submitted to facilities@cccm.com for screening and approval.
6. Reminder: If you are staff member, and new to the state of California, you will need to obtain a new California Driver’s License (CDL) with the California DMV (www.dmv.ca.gov).

Blessings,
Fleet Administration
Calvary Facilities,
Calvary Chapel Costa Mesa
facilities@cccm.com
(714) 556-7404
Choosing Safe Drivers for Your Ministry

Brotherhood Mutual

An important part of your ministry is providing safe transportation-be it shuttling the disabled for Sunday Morning Services, driving the youth group to a retreat, or taking preschoolers on a field trip. Screening your drivers before they get behind the wheel is critical to ensuring that those in your care are in good hands.

Plan to select at least one primary qualified driver for each vehicle your ministry owns. Keep a list of all approved, trained drivers, and avoid situations where people not on the list are thrust into the drivers seat.

You can screen your drivers by using the following criteria.

1. Proper Licensing

Make sure your drivers are properly licensed for the vehicles they will operate. Most states require a commercial driver license (CDL) for driving buses and large vans. Generally, a commercial license is needed if the vehicle weighs more than 26,000 pounds or is designed to transport more than 16 people (including the driver). Check with your local Department of Motor Vehicles for the CDL requirements in your state.

2. Age

Carefully consider the age of potential drivers. Those under 21 or over 65 pose considerably greater risk for auto accidents, according to the Insurance Institute for Highway Safety. Young drivers, regardless of maturity, lack behind-the-wheel experience-particularly when it involves transporting others. Elderly drivers may have slower reaction times and physical or visual impairments.

3. Experience and Training

Identify drivers with as much experience as possible. Drivers of any age who haven't driven often are more likely to have accidents. Choose drivers that are specially trained to handle a larger van or bus. The most severe accidents are usually caused by a drivers lack of understanding of the handling dynamics of longer vehicles, which are more prone to rollover cars.

*Note: A helpful link to a video presentation entitled "Defensive Driving for 15-Passenger Vans", is designed to help van drivers to respond safely to potential collision producing situations. (This YouTube video presentation can be viewed at: https://youtu.be/dBPKt4Pctsg).

4. Driving Record

Obtain candidates' driving records. Looking for people without reckless driving citations or multiple moving violations. Your ministry may be judged negligent for allowing someone with a poor driving record to operate a vehicle.

Your ministry may want to consider working with a background screening provider to obtain reliable driving records as well as other background checks such as criminal history reports and sex offender registry checks.

To learn more about checking driving records, visit the background screening section of Brotherhood Mutual's website: www.brotherhoodmutual.com
Name of Ministry
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Date of Birth Date of Birth / MM / DD YYYY
Driver's License Number
Driver's License State Issued
Is this a commercial driver's license?

Is this a commercial driver's license? Yes No
Which vehicle will you be driving?

Make
Model
Year
Are you the primary driver? *You drive the vehicle more than once per month or more than 12 times a year.

Are you the primary driver? *You drive the vehicle more than once per month or more than 12 times a year. Yes No
In the past three years:

Have you been at fault for any accidents?

In the past three years: Have you been at fault for any accidents? Yes No
Have you had any moving traffic violations?

Have you had any moving traffic violations? Yes No
Have you had any insurance company cancel or refuse to provide you with auto insurance?

Have you had any insurance company cancel or refuse to provide you with auto insurance? Yes No
Have you had your driver's license revoked, suspended, or restricted?

Have you had your driver's license revoked, suspended, or restricted? Yes No
Have you ever had any physical impairments other than corrective glasses?

Have you ever had any physical impairments other than corrective glasses? Yes No
Have you ever been charged with or convicted of "driving while intoxicated" or "driving under the influence"?

Have you ever been charged with or convicted of "driving while intoxicated" or "driving under the influence"? Yes No
If any question(s) 1-6 have been answered with "yes", please provide full details below: (dates, descriptions, amounts, or other explanations)
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
Calvary Chapel Costa Mesa Driver’s Information Name Calvary Chapel Costa Mesa Driver’s Information

Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Mobile Phone Mobile Phone - ### - ### ####
Email Address
Emergency Contact Name Emergency Contact Name First Last
Emergency Contact Phone Number Emergency Contact Phone Number - ### - ### ####
Emergency Contact Mobile Phone Emergency Contact Mobile Phone - ### - ### ####
I work or volunteer for...
As a Calvary Chapel Costa Mesa authorized driver, I agree to the following:

I will only check out vehicles that I will be driving.

As a Calvary Chapel Costa Mesa authorized driver, I agree to the following: I will only check out vehicles that I will be driving. I agree
If I do not have a Class B driver's license with a passenger endorsement, I will not drive 10 or more passengers in the vehicle I am driving.

If I do not have a Class B driver's license with a passenger endorsement, I will not drive 10 or more passengers in the vehicle I am driving. I agree
If I do not have a Class B driver's license, I agree not to drive any commercial vehicles that require a Class B driver's license.

If I do not have a Class B driver's license, I agree not to drive any commercial vehicles that require a Class B driver's license. I agree
In case of an accident of any kind, I will contact Calvary Facilities at (714) 556-7404, or Security at (714) 788-3293.

In case of an accident of any kind, I will contact Calvary Facilities at (714) 556-7404, or Security at (714) 788-3293. I agree
I will be held responsible to return all church vehicles in the condition that the vehicle was in when it was checked out.

A. Vehicle will be refueled
B. Vehicle will be clean inside and outside

I will be held responsible to return all church vehicles in the condition that the vehicle was in when it was checked out. A. Vehicle will be refueled B. Vehicle will be clean inside and outside I agree
I will not take the Toll Roads or Express Lanes that require a transponder. I understand I will be responsible for Toll or Express lane violations.

I will not take the Toll Roads or Express Lanes that require a transponder. I understand I will be responsible for Toll or Express lane violations. I agree
I acknowledge that I have read and understand the guidlines and procedures for driving any of the Church, Conference Centers, and/or any rented vehicles under Calvary Chapel Costa Mesa.

*Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
Upload a copy of your DMV driving record.
Upload a copy of your driver's license.

Ministry Driver Screening

Ministry Driver Screening

Application for CCCM Authorized Ministry Driver:

Choosing Safe Drivers for Your Ministry