SOU Facilities, Management & Planning
Driver Clearance Form

E-mail:
Department:
Index Code ($5.00 per record):
Submitter Name:
Submitter Phone:
Driver Name:
Date of Birth
Oregon Driver's License:
Driver Phone:
Status:
Will you be taking passengers in a van?
If yes, when do you need to be certified by?
Certification Due:
Other Info:
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