• CCT DRIVER'S APPLICATION FOR EMPLOYMENT

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  • In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status .

  • TO BE READ AND SIGNED BY APPLICANT

    I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.
    In the event of employment, I understand that false or misleading information given in my application or inter­view(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.
    I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

    • Review information provided by previous employers;
    • Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
    • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

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  • List your addresses of residency for the past 3 years.

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  • Employment History

    All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code.

    Applicants to drive a commercial motor vehicle* in interstate or interstate commerce shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle.

    (NOTE: List employers in reverse order starting with the most recent. Add another sheet as nescessary.)

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  • *Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport hazardous materials in a quantity requiring placarding.

    The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 lbs. or more, (2) is designed or used to transport more than 8 passengers (including driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

  • Accident Record

    FOR PAST 3 YEARS OR MORE. IF NONE, SELECT NONE

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  • Traffic Convictions

    FOR PAST 3 YEARS OR MORE. IF NONE, SELECT NONE

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  • Experience and Qualifications

    List all driver licenses or permits held in the last 3 years

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  • Education

    Choose highest grade completed for the following:

  • TO BE READ AND SIGNED BY APPLICANT

    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.

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  • Authorization Form for Consumer Reports

    In connection with your application for employment (including contract for services), understand that consumer reports or investigative consumer reports which may contain public record information may be requested or made on you including consumer credit, criminal records, driving record, education, prior employer verification, workers compensation claims and others. These reports will include experience information along with reasons for termination of past employment. Further, understand that information from various Federal, State, local and other agencies which contain your past activities will be requested. A consumer report containing injury and illness records and medical information may be obtained only after a tentative offer of employment has been made.

    By signing below, you hereby authorize without reservation, any party or agency contacted by this employer to furnish the above mentioned information. You further authorize ongoing procurement of the above mentioned reports at any time during your employment (or contract). You also agree that a fax or photocopy of this authorization with your signature be accepted with the same authority as the original.

    You have the right to make a request of First Advantage, upon proper identification and the payment of any legally permissible fees, for the information in its files on you at the time of your request.

    You hereby authorize and request, without any reservation, any present or former employer, school, police department, financial institution, division of motor vehicles, consumer reporting agencies, or other persons or agencies having knowledge about you to furnish First Advantage with any and all background information in their possession regarding you, in order that your employment qualifications may be evaluated.
    For California, Minnesota or Oklahoma applicants only, if you would like to receive a copy of the consumer report, if one is obtained, please check this box. D If checked and you are a California applicant, a copy of the consumer report will be sent within three (3) days of the employer receiving a copy of the consumer report.
    For California applicants only, if public record information about your character, general reputation, personal characteristics, and mode of living is obtained without using a consumer reporting agency, you will be supplied a copy of the public record information within seven (7) days of the employer's receipt unless you check this box where you hereby waive your right to obtain a copy of the consumer report.

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  • Job Application Questionaire

     

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