Driver Questionnaire

Annual survey to be completed by anyone who drives school vehicles OR who drives under the school occasional business use insurance.
Name: 


A red asterisk (*) indicates required questions.

  1. Have you been involved in any motor accidents or made any claims for loss or damage (other than windscreen claims) in the last 5 years? *
    Yes
    No


  1. Have you ever had any motor vehicle insurance declined, cancelled, or refused?

    *
    Yes
    No


  1. Have you been convicted of any driving offences (including fixed penalty notices) in the last 5 years? Or do you have any prosecutions pending? *
    Yes
    No


  1. Have you been disqualified from driving at any point in the last 11 years?

    *
    Yes
    No


  1. Do you suffer from any medical condition or disabilities that are notifiable to the DVLA? *
    Yes
    No


  1. Are you taking any medication that may impair your ability to drive? *
    Yes
    No


  1. If you have answered YES to any of the above questions, 1-6, please provide full details.


  1. The next 4 questions are mandatory for staff / volunteers who drive their own vehicle using the school occasional business use insurance. If you are unsure if this applies to you please ask Louise Green.

    Does your motor insurance policy extend to include cover for business use?

    Yes
    No


  1. If you vehicle is more that 3 years old, does it have a valid MOT certificate?
    A copy of this need to be held as part of the school insurance files, please provide a copy of this to the Louise Green.
    Yes
    No


  1. Is your vehicle serviced in line with the manufacturer’s recommendations?
    Yes
    No


  1. Does your vehicle have valid vehicle tax in place?
    Yes
    No


  1. We also need to confirm certain details from your driving licence for which we need a ‘Licence check code’ from the DVLA. Please visit https://www.gov.uk/view-driving-licence to generate this code, via the ‘Share your licence information’ tab.


  1. Please confirm that you have provided the details to question 12 or confirm that you are happy for a member of staff to complete the licence checks on your behalf. *
    Yes
    No


  1. Please provide a copy of your driving license to Louise Green to hold as part of the annual checks.
    I hereby declare that the above statements are true and that there are no other material facts that need to be disclosed. Furthermore, I agree to advise the company immediately of any changes in the above particulars. *





OSH