Instructions for MVR Authorization Request Form:
PLEASE NOTE: This form is one of two steps to complete the process of being cleared to drive for William Jessup University and be added to our insurance policy. Once you have filled in your name and email, you will need to download the MVR form (below), complete, sign and upload your MVR form here on this page.
Please use the “MVR Request Upload” field to attach a copy of your proof-of-insurance and driver’s license along with your completed MVR form.
Your documents may be uploaded as a scanned PDF or a clear picture file (JPG only).
If you have any questions, please email Marcie Lemos @mlemos.jessup.edu
I am aware that consumer and motor vehicle reports may be obtained as part of William Jessup’s evaluation of my job application and/or employment. The reports may be procured by William Jessup University or its insurance company representative(s), and may include information obtained from state motor vehicle departments, my driving record or an assessment of my insurability for the insurance program.
By filling out this form, I hereby provide my authorization for William Jessup University or their insurance company representative(s) to procure such information and reports to evaluate my insurability.
Please download, complete, sign and upload this form: MVR FORM