Defensive Driving Course Request

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Employee Accident With or Without Injury

Worker Injuries

Find a Clinic to treat an Injury

Click here to find closest treating Doctor or Hospital

Injured Worker Help:

In an Emergency Call "911"
Call your supervisor ASAP.
Non-Emergency Related injuries can use the link above to find a clinic to care for the worker.
Call Safety Manager to inform of the injury: Ed Porter 210-471-8839.
Manager/Coordinator
must go to "Fleet and Safety Page" and complete the First
Report of Injury Form to report the injury even if they did not require medical treatment....this must be done within 24 hrs of the injury.
All Auto Accidents must have someone complete Auto Accident Report on the Fleet and Safety Page.

Defensive Driving Course Request

Please complete all information to request the Defensive Driving Course for an employee prior to driving our fleet vehicles.

Thanks so much,
Fleet Manager


System Manager Authorizing Request*

Personal Information
First Name:*
Last Name:*
Home Office:
Department
Current/Active Driver's License Number:*
DL Expiration Date:*
DL State:
Email Address:*
Phone #:*
Last MVR Date listed in Penguin:*
Date of Birth:*
Are you between the age of 25-70?*
Have you had more than two minor Traffic Violations in the past three (3) years?*
In the past (5) five years have you been convicted of any of the following? Drug Conviction DWI/DUI Vehicular Manslaughter*
Do not enter anything in this field:

* indicates a required field

Please fill this field.

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Broadband Telecom Services
601 Bear Cat Rd
Aledo, TX 76008

Office: 817.441.9386

In an Emergency Call "911"

Call your supervisor ASAP.

Non-Emergency Related injuries can use the link above to find a clinic to care for the worker.

Call Safety Manager to inform of the injury: Ed Porter 210-471-8839.

Manager/Coordinator must go to "Fleet and Safety Page" and complete the First Report of Injury Form to report the injury even if they did not require medical treatment....this must be done within 24 hrs of the injury.

All Auto Accidents must have someone complete Auto Accident Report on the Fleet and Safety Page.

Manager/Coordinator
must go to "Fleet and Safety Page" and complete the First
Report of Injury Form to report the injury even if they did not require medical treatment....this must be done within 24 hrs of the injury.