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)
CRITERIA FOR LENS CHECK:
- 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:
- 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.
- Has been convicted of more than three Moving Vehicle and Traffic Law violations during the past 12-month period.
- Has been involved in two or more accidents that are recorded in the Motor Vehicle Record during the past 24-month period.
- Has been convicted of reckless driving in the past 36-month period.
- Has been convicted of leaving the scene of an accident or failure to report an accident during the past 36-month period.
- Has been convicted of vehicular assault.
- 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.
