For-Hire Driver Application (NEMT) Submit online at unitedtransportationservicesinc.net or email: [email protected] Full Name Date of Birth (MM/DD/YYYY Phone Email Driver’s License Number State of Issue CDL Class (A/B/C or None) For-Hire License # (if any Years of Driving Experience Vehicle Experience (check all that apply): Wheelchair Van Stretcher Van Passenger Van Sedan Availability Full-Time Part-Time Signature I certify the information provided is true and accurate. I authorize United Transportation Services Inc. to obtain my Motor Vehicle Record (MVR) and conduct a background check as permitted by law. Send your message