• Driver Application

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

  • To Be Read and Signed by Applicant

    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 resend the corrected information to the prospective employer; and
    • Have a rebuttal statement attahced to the alleged erroneous information, if the previous employer(s) and I cannot agree on the acuracy of the information.
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  • Applicant to Complete

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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 intrastate or interstate commerce shall provide the past 10 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 if necessary.)

  • Employment

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  • Employment

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  • Employment History Cont.

  • Employment

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  • Employment

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  • Employment

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  • Employment History Cont.

  • Employement

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  • Employement

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  • *Includes vehicles having a GVWR of 26,001 lbs, or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a qantity requiring placarding.

  • **The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in intersate commerce to transport passengers or property when the vehicle: (1) weighs or has GVWR of 10,001 lbs. or more (2) is designed or used to transport more than 8 passengers (including the 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
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  • Traffic Convictions

    And forfeitures for the past 3 years (other than parking violations).
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  • Driver Experience and Qualifications

    Driver Licenses or Permits held in the past 3 years
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  • Driving Experience

  • Class of Equipment

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  • Education

  • Personal References

  • I authorize you to make such investigations and inquiries of my personal, employment, and/or medical history and other related matters as may be necessary in arriving at a decision. 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 termination. I understand, also, that I am required to abide by all rules and regulations of the Company.

  • 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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  • Should be Empty:
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