Clean Fleet Auto Body
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Before & After
Family Application Form
Do you have a current Driver's License? *If yes please email a current DMV driving record report with application.
Driver's License Number
Has your driver’s license ever been suspended or revoked?
Have you had any moving violations or criminal infractions in the past two years?
Do you currently have auto insurance?
Are there any other members of your household with a current valid drivers license?
Can you drive a manual/stick shift transmission car?
This event will be covered by the media, are you willing to appear on TV?
Are you currently employed?
If yes, please list the name, address and telephone number of your employer/supervisor.
All interested applicants must send a 1 page narrative explaining why the lack of reliable transportation interferes with your current and future economic status, and how receiving this automobile will assist you in becoming self-sufficient, along with their resume, and current DMV driving record report. These can be dropped off to Clean Fleet Auto Body at 4432 Hearst Street Metairie LA 70001, faxed to 504-888-0507, or emailed to
All applications are due by October 1st, 2015.
Yes, I understand.
Thank you for submitting your application. Recipient will be notified in October.
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