APPENDIX D: VAN OPERATION
Policy 7303: Fifteen (15) Passenger Vans
VAN OPERATION
Longwood University Police Department
I understand the below listed information regarding the Longwood fifteen (15) passenger van policy, and I have had the opportunity to ask for clarification of all items. Furthermore, I understand that signing this document grants permission to the Longwood Public Safety Department to access my driver's history information.
1. I have authorized the Longwood Public Safety Department to validate the status of my driver's license and access my driving history prior to a road test. I will not be permitted to operate a van on Longwood sponsored activities if I have been convicted of a serious traffic offense, have had three (3) accidents, or three (3) speeding tickets within the past three (3) years.
2. I have agreed to complete a driving test under Longwood Public Safety Department supervision. This is a standardized test and the results will be maintained on file for a minimum of three (3) years.3. I have been shown where the spare tire, jack, etc. are located. I have also been informed to contact the Police Dispatch at 434.395.2091 should a more serious maintenance problem occur.
4. I have been shown the location of the instructions "When You Have An Accident." I have read these instructions. I have been made aware that should I have an accident, I am not to move the vehicle before the police arrive at the scene and authorize me to do so.
5. I agree that I will wear my seat belt. It is the law.
6. I have been instructed in the use of and location of gas credit cards. I understand they must have the vehicle license number, mileage and a legible signature. I am also aware that the receipts are to be turned in with the keys at the end of the trip.
7. It is my responsibility to leave the van clean. All trash is to be removed.8. I am aware that smoking and the consumption of alcoholic beverages in state owned vehicles are prohibited.
Printed Name:___________________________________
Signature:_______________________________________
SSN:______________________DOB:________________
Officer's Name (Printed): ___________________________
Signature:_______________________________________