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Midland Evangelical

Free Church

Sunday Worship 9:00 & 10:45 AM

The Portal

Volunteer Application: Part 4-Driving Record Check

PART 4: DRIVING RECORD CHECK

Log into or create a Portal account for a quicker registration experience by clicking "Login" above! Once logged in, your contact information will auto-populate.

Part 4 must be updated each year if you drive a vehicle as part of your volunteer service to the church.

*For which ministry are you completing this form?:
*Date of Birth:
*Are you between the ages of 25 and 70?:
*Driver's license number:
*State of issue:
*Expiration Date:
*Type of License:
Please note any restrictions on your driver’s license:
NOTE:
1. Driver is obligated to inform Midland Free if he/she receives a traffic citation after this form has been completed.

2. Please indicate any of the following moving violations that you have had during the past 3 years. This does not necessarily exclude you from driving for a Midland Free ministry.

Major Violations:
Minor Violations

RELEASE

I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGNED THIS RELEASE AS MY OWN FREE ACT. This is a legally binding release which I have read and understand. I understand that I may consult with an attorney before signing this document. A printed copy of this electronic original authorization shall be as valid as the original.

I recognize that Midland Free requires all applicants under the aforementioned conditions to undergo investigative background inquiries. This includes a Motor Vehicle report. I understand this report may be repeated as often as Midland Free deems necessary.
*Electronic Signature:
*Email:
If a copy of this agreement is needed please contact the MEFC office at 989-631-4411.