Use the form below to apply for our CDL Truck Driver position.
First Name *
Last Name *
Phone *
Email *
Date Of Birth *
Position Applied For *
Date Available For Work *
Do You have Legal Right To Work in The United States? * YesNo
Please include street, city, state, and zip code.
Current Address *
Second Most Recent Address
Third Most Recent Address
Fourth Most Recent Address
State *
License Number *
Type/Class *
Endorsements *
Expiration Date *
Previously held licenses
Class of Equipment * —Please choose an option—Straight TruckTractor & Semi-TrailerTractor & 2 TrailersTractor & Tanker
Type of Equipment * —Please choose an option—VanTankFlatOther
Date From *
Date To *
Approximate Miles Driven *
Class of Equipment —Please choose an option—Straight TruckTractor & Semi-TrailerTractor & 2 TrailersTractor & Tanker
Type of Equipment —Please choose an option—VanTankFlatOther
Date From
Date To
Approximate Miles Driven
Nature of Accidents (List dates, fatalities, injuries, and chemical spills) *
Violations (List dates, violations, state of violation, and penalty) *
Have you ever been denied a license, permit, or privilege to operate a motor vehicle? * YesNo
Have you ever had a license, permit, or privilege suspended or revoked? * YesNo
Name *
Address *
Position Held *
From *
To *
Reason For Leaving *
Salary *
Explain Any Gaps In Employment (include month/year & reason)
While employed here, were you subject to the Federal Motor Carrier Safety Regulations? * —Please choose an option—YesNo
Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40? * —Please choose an option—YesNo
Name
Phone
Address
Position Held
From
To
Reason For Leaving
Salary
While employed here, were you subject to the Federal Motor Carrier Safety Regulations? —Please choose an option—YesNo
Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40? —Please choose an option—YesNo
Name & Location *
Years Completed *
Graduate * —Please choose an option—YesNo
Details
Name & Location
Course of Study
Years Completed
Graduate —Please choose an option—YesNo
Please list any other qualifications that you have and which you believe should be considered.
It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty.
It is agreed and understood that the motor carrier or his agents may investigate the applicant’s background to obtain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and person named herein from all liability for any damages on account of his furnishing such information.
I agree to furnish such additional information and complete such examinations as may be required to complete my application file.
It is agreed and understood that this Application in no way obligates the motor carrier to employ or hire the applicant.
It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse.
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Applicant Digital Signature *
Date *