Driver Registration

If you would like more info on your registration, please do not hesitate to contact us through any of the methods at the bottom of the page.

1. Personal Information

First Name

Last Name

Birth Date

Gender

Male Female

Mailing Address

Physical Address

Phone Number

Cell Number

Languages Spoken

English French

2. Driving licenses and insurance

License class

License number

License expiration date

Years of experience

Name of Insurance Company

Insurance Limit for Bodily Injury

Insurance Limit for Damage to Property

Certificate of Inspection Expiration Date

Make and model of the vehicule used as a part of your volunteer work

Vehicule manufacture year

3. Training and experience

Have you ever received road safety courses?

Yes No

If so, which organization has offered these courses?

In which year?

Have you taken a first aid course or CPR course?

Yes No

If so, is your certification still valid?

Yes No

Have you had accidents on the road, received tickets for driving infractions, or been arrested for driving while intoxicated in the last 5 years? If yes, please elaborate.

The Chaleur Transportation Cooperative is authorized to request a copy of the volunteer's driving record summary provided by Service New Brunswick in case of reasonable doubt. Costs to get the case summary of Service New Brunswick may be reimbursed by the Chaleur Transportation Cooperative.

Do you suffer from health problems or do you have medical prescriptions that could affect your driving?

Yes No

Are there times of the year when you will not be available?

Yes No

6. Select the regions you are willing to travel to

7. References

Please provide the names of three references and their phone numbers (excluding family members) who can attest to your ability to drive.

First Name

Last Name

Phone Number

First Name

Last Name

Phone Number

First Name

Last Name

Phone Number

8. Select the type of transportation you are willing to provide

I certify that the information provided on this form is accurate and complete. I understand that any false statement may lead to refusal or revocation of my registration with the Chaleur Transportaion Cooperative. I undertake to respect the rules and regulations of the service. I understand that only information necessary for my travel, my safety and comfort will be transmitted to drivers/CTC organizers/volunteers who will offer me the service.

A 40 Km Trip for Ride-Home may cost as little as $14

Driver Registration

1. Personal Information

2. Driving licenses and insurance

3. Training and experience

4. Health

5. Availability

6. Select the regions you are willing to travel to

7. References

8. Select the type of transportation you are willing to provide

A 40 Km Trip for Ride-Home may cost as little as $14

Volunteer drivers are reimbursed for mileage and compensated for additional insurance requirements.