NONEMERGENCY MEDICAL TRANSPORTATION DRIVER Emmanuel Medical Transport LLC is in need of a responsible independent contractor to provide non-emergency medical transportation (NEMT) throughout North Carolina. The primary role of the NEMT driver will be to ensure the safe and timely arrival of all passengers to their destination. INDEPENDENT CONTRACTOR APPLICATION Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Are you 18 years of age and properly licensed to operate a motor vehicle? * Yes No Do you have no more than two (2) chargeable accidents or moving violations in the past three (3) years? * Yes No Has your driver's license been suspended or revoked within the past five (5) years? * Yes No Are you reliable, punctual and willing to display a pleasant attitude while executing duties? * Yes No Have you been convicted, plead guilty or no contest to any of the following crimes: murder; rape or aggravated sexual abuse; kidnapping or hostage taking; assault inflicting serious bodily injury; a federal crime of terrorism; unlawful possession, use, sale, distribution, or manufacture of an explosive device; unlawful possession, use, sale, distribution, or manufacture of a weapon; elder abuse/exploitation; child abuse/neglect; illegal sale or possession of a Schedule I or II controlled substance; or conspiracy to commit any of the aforementioned? * Yes No In order for your application to be considered, you must email a copy of your driving records to administrator@LetUsDriveNC.com. Do you agree to do so? * Yes No Message Please share with us any additional information you deem relevant. Phone * (###) ### #### Thank you!