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Facilities and Planning

The College at Brockport LENS Request Form

(License Event Notification System)

I, _________________________ , hereby authorize Human Resources to verify my driver's license information.  This is a DMV record check to determine my eligibility to drive a College leased/rented vehicle (van).

Information from Driver's License:

Driver's License ID#: 

Name: (First, Last): 

Date of Birth: (Month, Day, Year): 

Male/Female (circle):      M            F

Please circle the following to indicate status on campus:

Faculty/Staff               Student

Signature:      Date: 

**  Please forward completed form to the Office of Human Resources  **

  (All information obtained from DMV is held strictly confidential)


  • An applicant who is less than 25 years of age and/or does not hold a valid New York State Driver's license is not eligible to drive a van.  Volunteers are not considered employees of The College at Brockport and are not eligible to drive a van.
  • An applicant would be precluded from operating a van if he/she:
    1. Has been convicted of any violation involving the use of alcohol or drinking or drugs while operating a motor vehicle in the past 36-month period.
    2. Has been convicted of more than three Moving Vehicle and Traffic Law violations during the past 12-month period.
    3. Has been involved in two or more accidents that are recorded in the Motor Vehicle Record during the past 24-month period.
    4. Has been convicted of reckless driving in the past 36-month period.
    5. Has been convicted of leaving the scene of an accident or failure to report an accident during the past 36-month period.
    6. Has been convicted of vehicular assault.
    7. Has been convicted of vehicular manslaughter.

The University reserves the right to deny a person the privilege to operate a State owned/leased van, whenever a determination has been made that such denial is in the best interests of the University.

Driving training (Van Safety II classroom and hands-on) must be completed to drive a van.  The Office of Facilities and Planning will maintain a log of approved VAN drivers.