• Driver Application

    Driver Application

    Please fill out completely and accurately, per MDOT requirements.

  • General Information

  • Have you resided at this address for at least 3 years?*
  •  -
  • Have you had any legal name changes?*
  • Have you ever been convicted of a crime?*
  • Are there any pending charges against you?*
  • Have you previously applied at Cordes Inc?*
  • If hired, can you furnish proof of eligibility to work in the United States?*
  • Are you 21 years of age or older?*

  • Employment History

    The U.S. Department of Transportation requires that the driver applicants show all employment for the past three years. Effective July 1, 1987, they must also show commercial driver employment for the seven years preceding this three year period. Sec. 391.21 (b) (10) (11). Account for any gaps in employment between employers.
  • Have you been previously employed at Cordes Inc?*
  • Are you currently employed?*

  • Please list current, or most recent employment first.

  •  -
  • Is this your current employer?*
  • May we contact this employer?*
  • Was this a driving position?*
  • Were you regulated by FMCSA at this job?*
  • Was this job a FMCSA safety sensitive function position subject to DOT regulated controlled substance and alcohol testing?*

  • NEXT EMPLOYER

  •  -
  • Was this a driving position?
  • Were you regulated by FMCSA during this job?
  • Was this job a FMCSA safety sensitive function position subject to DOT regulated controlled substance and alcohol testing?

  • NEXT EMPLOYER

  •  -
  • Was this a driving position?
  • Were you regulated by FMCSA during this job?
  • Was this job a FMCSA safety sensitive function position subject to DOT regulated controlled substance and alcohol testing?

  • NEXT EMPLOYER

  •  -
  • Was this a driving position?
  • Were you regulated by FMCSA during this job?
  • Was this job a FMCSA safety sensitive function position subject to DOT regulated controlled substance and alcohol testing?

  • NEXT EMPLOYER

  •  -
  • Was this a driving position?
  • Were you regulated by FMCSA during this job?
  • Was this job a FMCSA safety sensitive function position subject to DOT regulated controlled substance and alcohol testing?

  • NEXT EMPLOYER

  •  -
  • Was this a driving position?
  • Were you regulated by FMCSA during this job?
  • Was this job a FMCSA safety sensitive function position subject to DOT regulated controlled substance and alcohol testing?

  • Driver Qualification & Experience

  • Have you held a valid US license for the past 3 years?*
  • CDL Endorsements*
  • Do you currently hold more than one valid license?*
  • Have you ever been denied a license, permit or privilege to operate a motor vehicle?*
  • Has any license, permit or privilege ever been suspended or revoked?*
  • Have you ever tested positive or refused a pre-employment drug test for a motor carrier that didn’t hire you in the last 3 years?*
  • Have you ever been disqualified for violations of the Federal Motor Carrier Safety Reg’s (including Drug & Alcohol)?*
  • Have you had any moving violations in the last 5 years?*
  • Have you had any accidents in the last 5 years?*

  • Additional Information

  • EDUCATION

  • Did you graduate/equivalent?
  • Did you graduate?

  • Disclosure Statement

    Applicant must read and sign before submitting this application.

  • It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty and reason for non-consideration or subsequent dismissal if hired or denial of authorization to drive.  It is also agreed and understood that the motor carrier and his agents may investigate the applicant’s background to ascertain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his/her furnishing such information.


    I authorize the motor carrier to access the FMCSA Pre-Employment Screening Program (PSP) to seek information regarding my commercial driving safety record and information regarding my safety inspection history.  I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. 


     I understand that nothing contained in this application or in the granting of any interview or a road test is intended to create an employment contract between this company and myself, for either employment, authorization to drive, or for the providing of any benefits.  I agree to furnish such additional information that may be necessary and complete such examinations as may be required to complete my application file including but not limited to a pre-employment negative urine test and successful completion of a human performance evaluation including a Department of Transportation Physical.  No promises regarding employment or authorization to drive have been made to me, and no such promises exist unless specifically made by this Company in writing.  It is agreed and understood that if qualified, hired, or contract started, I may be on a probationary period during which time I may be disqualified without recourse.  I understand employment or authorization to drive with this carrier is on an “at-will” basis that allows me to quit, be fired, or lease agreement revoked at any time with or without notice and with or without cause.  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.

  • By this document, Motor Carrier Name discloses to you that a consumer report, including an investigative report containing information as to your character, general reputation, personal characteristics, driving record, and mode of living may be obtained as part of a background investigation as part of the Motor Carrier Name’s driver qualification process.  Should an investigation consumer report be requested you have the right to demand a complete and accurate disclosure of the nature and scope of the investigation requested and a written summary of your rights under the Fair Credit Reporting Act.  Please sign below to signify receipt of the foregoing disclosure.
     

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  • Date
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