Des Moines Christian School

Application for Employment

Pre-employment Drug Test

Acknowledgement Form

I, ____________________________________, have been informed of the requirement to submit a drug test prior to being employed by Des Moines Christian School to perform a safety sensitive function.   I consent to submit to the drug and alcohol testing program required by the Drug and Alcohol Testing Program Policy, its supporting administrative regulations, and the law.

I understand that the results of my drug test will be shared with Des Moines Christian School; and if I have a positive drug test result, I understand that I will not be considered for further employment with Des Moines Christian School.  I further understand that the drug and alcohol testing records and information about me is confidential, and may only be released at my request or in accordance with the law.

Signature _______________________________________________ Date_______________

Des Moines Christian School

Application for Employment

Additional Questions for Bus Driver Applicants

Please provide answers to the following questions.

What is your commercial driver’s license number? ______________________________________________

When did you complete your bus driver training course? _________________________________________

Have your driving privileges ever been revoked?  If yes, please provide the reason:

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Have you had any moving violations in the past five years?

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