Form R-394 "Application for New Master Instructor" - Connecticut

What Is Form R-394?

This is a legal form that was released by the Connecticut Department of Motor Vehicles - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2013;
  • The latest edition provided by the Connecticut Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form R-394 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Motor Vehicles.

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Download Form R-394 "Application for New Master Instructor" - Connecticut

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APPLICATION FOR NEW MASTER
INSTRUCTOR
STATE OF CONNECTICUT
R-394 New 10-2013
DEPARTMENT OF MOTOR VEHICLES
DRIVER EDUCATION UNIT
Full name of applicant (Last, First, MI)
Employer
Home Address
Address
City, State, Zip
City, State, Zip
Daytime Phone
Email
Phone
Fax
Date of Birth:
Connecticut Operator's
License Number:
Place of Birth:
Classifications and
Class:
A
B
C
D
(City & State)
Public Transportation
Endorsements:
A
V
S
P
F
Endorsements:
Number of Years
Restrictions:
L
K
B M N
(Circle all applicable)
Licensed:
High School Education:
Number of
(School Name and year
Years School
of Graduation)
Bus Driver:
Have you ever been refused a driver's license by
any state? If so, explain.
Has your license or registration ever been
revoked or suspended in any state?
If so, explain.
Have you ever been convicted or fined for a motor
vehicle violation other than parking?
(If yes, give dates and offenses).
Have you ever been convicted of a crime?
Give dates and offenses.
How long have you been a certified school bus
driver trainer?
Instructor's Number:
Certification: I certify under penalty of false statement (per CGS §14-110 ref. 53a-157) that the above information is
true and accurate on the date of this application.
Applicant's Signature
Date
I recommend this applicant for approval as a master instructor. He/she is employed by me and is a proficient driver with good
communication skills. Upon successful completion of training, the applicant will be utilized as a master instructor.
Employer's Signature
Date
Send Completed and Signed Applications to:
DMV - Driver Education Unit, 60 State Street, Room 305, Wethersfield, CT 06161
FOR DMV USE ONLY
Approval granted
Date
Signed
APPLICATION FOR NEW MASTER
INSTRUCTOR
STATE OF CONNECTICUT
R-394 New 10-2013
DEPARTMENT OF MOTOR VEHICLES
DRIVER EDUCATION UNIT
Full name of applicant (Last, First, MI)
Employer
Home Address
Address
City, State, Zip
City, State, Zip
Daytime Phone
Email
Phone
Fax
Date of Birth:
Connecticut Operator's
License Number:
Place of Birth:
Classifications and
Class:
A
B
C
D
(City & State)
Public Transportation
Endorsements:
A
V
S
P
F
Endorsements:
Number of Years
Restrictions:
L
K
B M N
(Circle all applicable)
Licensed:
High School Education:
Number of
(School Name and year
Years School
of Graduation)
Bus Driver:
Have you ever been refused a driver's license by
any state? If so, explain.
Has your license or registration ever been
revoked or suspended in any state?
If so, explain.
Have you ever been convicted or fined for a motor
vehicle violation other than parking?
(If yes, give dates and offenses).
Have you ever been convicted of a crime?
Give dates and offenses.
How long have you been a certified school bus
driver trainer?
Instructor's Number:
Certification: I certify under penalty of false statement (per CGS §14-110 ref. 53a-157) that the above information is
true and accurate on the date of this application.
Applicant's Signature
Date
I recommend this applicant for approval as a master instructor. He/she is employed by me and is a proficient driver with good
communication skills. Upon successful completion of training, the applicant will be utilized as a master instructor.
Employer's Signature
Date
Send Completed and Signed Applications to:
DMV - Driver Education Unit, 60 State Street, Room 305, Wethersfield, CT 06161
FOR DMV USE ONLY
Approval granted
Date
Signed