SAN JOSE UNIFIED ETUNING VOLUNTEE DIVE PACKET VOLUNTEE DIVE S NAME: STUDENT NAME /ID# SCHOOL: SPOT/ACTIVITY: STUDENT NAME /ID# SCHOOL: SPOT/ACTIVITY: STUDENT NAME /ID# SCHOOL: SPOT/ACTIVITY: STUDENT NAME /ID# SCHOOL: SPOT/ACTIVITY: PLEASE FOLLOW CHECKLIST INSTUCTIONS. VOLUNTEE DIVE PACKETS WILL NOT BE POCESSED UNLESS IT CONTAINS ALL EQUIED DOCUMENTS.ALLOW (10) BUSINESS DAYS TO POCESS. k Mmt: M v 8.20.15 P 1
Thk you for your trt voutr to trport S Jo Uf tut u your pro vhc. It oy cry to compt o SJUSD voutr rvr pckt. Ay ut trport tut for choo poor trp/thtc mut compt th Voutr Drvr Pckt Th foow yr thrftr you w to compt tur Voutr Drvr Pckt. k Mmt w otfy th choo t wh rvr uthorzto h b compt. Voutr w b otf by m or Prtk wh xprto of rvr c cr rtrto / or uto urc xpr. If you hv y quto you my cotct th crtry t your ch choo or k Mmt t 408-535-6510 Icu th pckt r two chckt o for No- Empoy/ prt o for mpoy/coch. Foow th tructo tht prt to you. CHECKLIST FO ETUNING NON-EMPLOYEE/PAENTS th Voutr Drvr Itructo Form Iurc Notc to Voutr Drvr trm by Cfor E. Co S Jo Uf Bor Pocy Cfor Vhc Hth /or Sfty Co. Attch y ocumt tht hv ch or w xpr: k Mmt: M v 8.20.15 Automob urc covr wth mt of ot th $100000 jury/th to o pro $300000 jury/th to mor th o pro. Th c b fou o th crto p of your pocy. Copy of urc tfcto cr. Copy of cr rtrto. Copy of BOTH of rvr c. Prov offc DMV ocumtto of your rv rcor for mmum of th t thr yr. Th K4 (3 yr htory) from t yr w xpr o yr from th y you rcv t. Th K4 my b obt two wy: Opto 1: Compt INF1125. Wrt your rvr c umbr pt or VIN o th frot or th bck of your $5 chck. At th top of th form wrt rqut CETIFIED rvr rcor m th form chck to th DMV hqurtr r o th form. Th my tk vr wk o p ccory Opto 2: Compt th INF1125 o to y DMV f offc to rqut th offc rport pro py $5. Compt t th Voutr Drvr trto Form. tur th compt p 1 5 o wth th cop of uto urc pocy mtto DMV rvr rcor (K4) cr rtrto rvr c to th choo crtry. P 2
CHECKLIST FO ETUNING EMPLOYEES/COACHES th Voutr Drvr Itructo Form Iurc Notc to Voutr Drvr trm by Cfor E. Co S Jo Uf Bor Pocy Cfor Vhc Hth /or Sfty Co. Attch y ocumt tht hv ch or w xpr: k Mmt: M v 8.20.15 Automob urc covr wth mt of ot th $100000 jury/th to o pro $300000 jury/th to mor th o pro. Th c b fou o th crto p of your pocy. Copy of urc tfcto cr. Copy of cr rtrto. Copy of BOTH of rvr c. Compt t th Voutr Drvr trto Form. tur th compt p 1 5 o wth th cop of uto urc pocy mtto cr rtrto rvr c to th choo crtry. t r t r o f o f P 3
SAN JOSE UNIFIED VOLUNTEE DIVE INSTUCTIONS 1.) A voutr rvr mut b 21 yr of or or po v Cfor rvr c or f h/h ort o ctv mtry uty Cfor po v c from h/hr tt of rc. To b pprov rvr h hv oo rv rcor. 2.) Th umbr of pr cu th rvr h ot xc th cpcty for whch th vhc w. Truck my ot trport mor pro th c fy t th pr comprtmt. Th rvr h ur tht th mufcturr rcommto for h/hr vhc r foow rr th t of chr t qupp wth rb. 3.) Th rvr or y othr pro h ot mok or hv h/hr mmt poo ht pp cr or crtt cot tobcco or y othr pt wh thr mor th motor vhc whthr th motor vhc moto or t rt. (Hth & Sfty Co 118948) 4.) A rvr h wr fty bt h ur tht pr r propry cur t bt or ch pr rtrt ytm ccorc wth w. (Vhc Co 27315 27360 27360.5 27363) 5.) A ch who ur 8 h b propry cur rr t pproprt ch pr rtr ytm mt fr fty tr xcpt ur y of th foow crcumtc: (Vhc Co 27360 27363) ) Th ch th 4 ft 9 ch or tr whch c fty bt my b u b) U of ch pr rtrt ytm wou b mprctc by ro of phyc uft mc coto or z pproprt pc ch pr rtrt by ytm ot vb c) Thr o rr t th rr t r fc jump t wr rr fc t ch pr rtrt ytm cot b t propry th rr t r ry occup by chr ur ht yr for mc ro ctt tht th ch ot r th rr t ) th ch othrw xmpt by w. 6.) A trffc w mut b oby. 7.) Tk th mot rct rout to th tto wthout ucry top. 8.) Trport oy tut who prt/ur hv v vc wrtt prmo to th choo. 9.) I c of mrcy kp tut tothr; c 911 th choo offc. 10.) Vhc mt f work orr. 11.) Th u of coho cotro ubtc mcto tht cou mpr th rvr bty to oprt th vhc f mr trcty prohbt. SAN JOSE UNIFIED INSUANCE NOTICE TO VOLUNTEE DIVES A voutr rvr I urt tht by u my utomob for trport tut o f trp thtc vt /or choo poor vt I m xpo myf to bty for jury to pr my vhc. I rz thr pobty of cct occurr th vt of jury to y of th occupt of my cr I urt tht I /or my urc compy my b b. I urt o tht th S Jo Uf Schoo Dtrct o ot prov urc covr for voutr rvr thr pc of or uppmtry to my pro utomob bty urc or y phyc m tht cou occur to my vhc. S Jo Uf urc protct th Dtrct oy th vt t hou b m ft. k Mmt: M v 8.20.15 P 4
SAN JOSE UNIFIED VOLUNTEE DIVE EGISTATION FOM DIVE INFOMATION Drvr (Chck tht ppy): Prt Empoy Coch Nm: Dt of Brth: Ar: Tpho: C Pho: Drvr Lc #: Drvr Lc C: Exp. Dt: Em Ar: VEHICLE INFOMATION Nm of Owr: Ar: Mk: Yr: Lc Pt #: trto Exprto: St Cpcty: VOLUNTEE DIVE STATEMENT I crtfy tht I hv ot b covct of rck rv or rv ur th fuc of ru or coho wth th pt 3 yr tht th formto v bov tru corrct. I urt tht f cct occur my urc covr h br prmry rpobty for y o or cm for m. I crtfy tht I hv r w b by th Drvr Itructo prov by th Dtrct. I hv r th Iurc Notc to Voutr Drvr urt I cou b b for y vhc m or jur wh trport SJUSD tut. PINT NAME VOLUNTEE DIVE SIGNATUE DATE EMPLOYEES/COACHES ONLY Job Locto: Job Tt: Nm of Amtrtor/ Athtc Drctor: k Mmt: M v 8.20.15 P 5
Prt Voutr Drvr DMV qut for K4 (3 yr rv rcor) fr to p 2 for t tructo. k Mmt: M v 8.20.15 P 6