Name *

Please type your legal name, as it appears on your State-issued ID or license.

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

A cell phone is required for this position. Please enter the number associated with your cell phone.

(###)

###

####

Date of Birth *

MM

DD

YYYY

Are you authorized to work in the US without a sponsor visa? *

Yes

No

Under penalties of perjury, I certify that: *

The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and I am a U.S. citizen or other U.S. person (defined below); and The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

I certify.

Did you graduate? *

Yes

No

Race and Ethnicity *

I choose not to self-identify at this time

Hispanic or Latino

White (Not Hispanic or Latino)

Black or African American (Not Hispanic or Latino)

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)

Asian (Not Hispanic or Latino)

American Indian or Alaska Native (Not Hispanic or Latino)

Two or More Races (Not Hispanic or Latino)

Gender *

I choose not to self-identify at this time.

I prefer the pronoun: Female

I prefer the pronoun: Male

Driver License Issue Date *

MM

DD

YYYY

Driver License Expiration Date *

MM

DD

YYYY

COVID-19: I agree not to drive for Communiride if I have tested positive for COVID-19 or have symptoms of COVID-19. *

I agree.

I will advise Communiride of any change in information provided on this form including, but not limited to, involvement in a car accident in which I am cited, any citations for moving violations, non-renewal of license, or termination of license. *

I agree.

I agree to send an image of my current driver's license and proof of insurance to support@communiride.com. Please use the next line to copy this email address prior to completing the application. *

support@communiride.com

I agree.

First and Last Name *

First Name

Last Name

Today's Date *

MM

DD

YYYY

Please confirm you read and understand the statement below: *

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. By typing your name below, you give representatives of Communiride LLC permission to use the information you provided above to generate a motor vehicle report and background check details. This application also serves as an agreement between Communiride, LLC and the applicant. Your typed name above will serve as your signature to this agreement.

I agree.