I understand that investigative background inquires are to be made concerning my motor vehicle driving record.

I authorize, without reservation, any party or agency contacted by this organization to furnish the above mentioned information.

I hereby give consent to Millikin University and/or its background check provider to obtain the above information to aid in the proper identification of my file and/or records, the following information, and I hereby furnish it without reservation.

Address:
Sign above

This release form alone does not grant the applicant to be a Millikin University authorized driver. The assigned on-line defensive driving course and tests must be successfully completed. On-line and password information will be sent to the email address listed. 

***The on-line defensive driving test must be completed within 30 days from the date the test are assigned.