Application For Employment Route Driver

Applicant Information

Applicant Name: *

First Name Middle Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Daytime Phone Number:

Area Code Phone Number

Driver’s License # & State Issued:

CDL Class:

Have you worked for Can Shed before:

When:

Position:

Emergency Contact Name:

Phone Number

Area Code Phone Number

Position Summary

Duties may include but are not limited to:
• Climbing in and out of trucks/trailers on a regular basis
• Lifting between 5 and 50 pounds repeatedly, occasionally over the head
• Repetitive movement of fingers, arms, legs and back muscles
• Repetitive tossing and/or throwing bags of cans and plastic into and out of trailers

Route managers are responsible for the following items, including but not limited to:

• Monitor and maintain vehicle fluid levels (fuel, oil, wiper fluid, etc.) with care to seasonal changes and needs
• Minor vehicle repairs
• Loading and unloading of the vehicle that is being used on a daily basis
• Prepping truck for the following day
• Accuracy on purchase/work orders including memos and notes for account changes
• Maintaining a good driving record and displaying a customer service outlook

Are you physically able to perform the physical requirements for this position?

PartTime/Full Time:

Date Available to Work:

Are you legally eligible for work in the United States of America (if chosen for this position, you will be required to prove your identity and eligibility)?

Are you at least 18 years of age?

Education

High School or Equivalent

School Name(s):

City/State:

Number of Years Completed:

1 2 3 4

Begin Date:

Date

Graduation Date

Date

Degree Obtained:

GPA:

Additional Information:

Undergraduate Experience

School Name(s):

City/State:

Number of Years Completed:

1 2 3 4

Begin Date:

Date

Graduation Date

Date

Major:

Degree/Certificate:

Minor(s):

GPA:

Employment History (List the last employer first)

Employment One

Name of Company:

Job Title:

Start Date:

End Date:

Starting Salary:

Ending Salary:

Reason for Separation:

Responsibilities:

Supervisor Name(s):

Phone Number

Area Code Phone Number

May we contact them (Y/N)?

Employment Two

Name of Company:

Job Title:

Start Date:

End Date:

Starting Salary:

Ending Salary:

Reason for Separation:

Responsibilities:

Supervisor Name(s):

Phone Number

Area Code Phone Number

May we contact them (Y/N)?

Employment Three

Name of Company:

Job Title:

Start Date:

End Date:

Starting Salary:

Ending Salary:

Reason for Separation:

Responsibilities:

Supervisor Name(s):

Phone Number

Area Code Phone Number

May we contact them (Y/N)?

Experience and qualifications

Class of Equipment

	Type (Van, tank, flat, etc.)	Dates	Approx. # of miles
Straight truck
Tractor and semi-trailer
Tractor and trailer
Forklift
Other

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? (Yes/No): If the answer to either question is yes, please attach a statement giving details.

List states operated in for the last five years:

Show special courses or training that will help you as a driver:

Show any trucking, transportation or other experience that may help in your work for this company:

List special equipment or technical materials you can work with other than those already shown:

Driving Record

In the last seven years, have you had any accidents?

If yes, how many?

Please describe below. Attach sheet if more space is needed.

	Dates	Nature/Cause of accident	Fatalities	Injuries
1
2
3

In the last seven years, have you had any traffic convictions?

If yes, how many?

Please describe below. Attach sheet if more space is needed. (Do not include parking violations)

	Location	Date	Charge	Penalty
1
2
3

Applicant Background

Do you have a current DOT medical card (YN)?

Position Background

Best time/day for a possible interview?

How did you hear about this position?

References

Professional References

Name:

Relationship:

Contact Information:

Professional References

Name:

Relationship:

Contact Information:

For Office use only

Date of pre-employment screening:

Start Date:

Department:

Position:

Starting Wage:

Medical Card expiration date:

Notes:

Acknowledgment

I, the applicant, certify that information included in this Job Application is true and absent of any falsification. I understand that if any of this information is found to be untrue, I will automatically be excluded from consideration for employment at Can Shed.

If I may become employed, I understand that I will follow the expectations in the code of conduct, which includes, but is not limited to, ethical behavior related to documentation. I understand that violating this policy and therefore falsifying information will lead to immediate dismissal from Can Shed.

I hereby release Can Shed from any/all liability of making a fair and impartial employment decision in compliance with the Equal Employment Opportunity Policy. I understand that if I become employed, both the employer and I have the right to terminate the relationship for any reason, at any time.

Signature of Applicant:

Date:

Application For Employment Route Driver (Class A CDL)