Partners, Corp. - Driver Application for Employment Logo
  • DRIVER'S APPLICATION FOR EMPLOYMENT

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  • Have you worked for Partners, Corp. before?         
    If "Yes", when?   Pick a Date   to   Pick a Date   
    Reason for Leaving?      

  • Personal History

  • List Your Address(es) of Residency for the Past 3 Years:

  • Current Address:   *      *   *   *   *   
    How Long at this address?  Years-*  Months-*       

  • Previous Address:                     
    How Long at this address?  Years-  Months-       

  • Previous Address:                     
    How Long at this address?  Years-  Months-       

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  • Employment History

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  • All driver applicants to drive in interstate commerce must provide information on ALL EMPLOYERS during the preceding 3 years, and all employers for whom the applicant drove a commercial motor vehicle for an additional 7 years.

    NOTE:
    List ALL Employers for the last 3 years
    List ALL Employers where you drove a Commercial Motor Venicle for the last 10 years
    Show any periods of unemployment greater than 30 days as an entry titled, "Unemployed", within chronological order of the listings.

  • Company:   *   
    Address:                  
    Phone:         
    Contact Name:         
    Employed From:   Pick a Date   to   Pick a Date   
    Reason for leaving?      
    Position?      
    Wage?      per      
    Were you subject to the FMCSR's while employed?         
    Was your job designated as a Safety-Sensitive function in any DOT-Regulated mode subject to the Drug and Alcohol Testing Requirements of 49 CFR Part 40?         

  • Company:      
    Address:                  
    Phone:         
    Contact Name:         
    Employed From:   Pick a Date   to   Pick a Date   
    Reason for leaving?      
    Position?      
    Wage?      per      
    Were you subject to the FMCSR's while employed?         
    Was your job designated as a Safety-Sensitive function in any DOT-Regulated mode subject to the Drug and Alcohol Testing Requirements of 49 CFR Part 40?         

  • Company:      
    Address:                  
    Phone:         
    Contact Name:         
    Employed From:   Pick a Date   to   Pick a Date   
    Reason for leaving?      
    Position?      
    Wage?      per      
    Were you subject to the FMCSR's while employed?         
    Was your job designated as a Safety-Sensitive function in any DOT-Regulated mode subject to the Drug and Alcohol Testing Requirements of 49 CFR Part 40?         

  • Company:      
    Address:                  
    Phone:         
    Contact Name:         
    Employed From:   Pick a Date   to   Pick a Date   
    Reason for leaving?      
    Position?      
    Wage?      per      
    Were you subject to the FMCSR's while employed?         
    Was your job designated as a Safety-Sensitive function in any DOT-Regulated mode subject to the Drug and Alcohol Testing Requirements of 49 CFR Part 40?         

  • Company:      
    Address:                  
    Phone:         
    Contact Name:         
    Employed From:   Pick a Date   to   Pick a Date   
    Reason for leaving?      
    Position?      
    Wage?      per      
    Were you subject to the FMCSR's while employed?         
    Was your job designated as a Safety-Sensitive function in any DOT-Regulated mode subject to the Drug and Alcohol Testing Requirements of 49 CFR Part 40?         

  • Company:      
    Address:                  
    Phone:         
    Contact Name:         
    Employed From:   Pick a Date   to   Pick a Date   
    Reason for leaving?      
    Position?      
    Wage?      per      
    Were you subject to the FMCSR's while employed?         
    Was your job designated as a Safety-Sensitive function in any DOT-Regulated mode subject to the Drug and Alcohol Testing Requirements of 49 CFR Part 40?         

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  • Commercial Driver Qualifications

  • Accident Record for the past 3 years (or more)...

  • Previous Accident:   Pick a Date   
    Nature of Accident:      
    Fatalities?            
    Injuries?         
    HazMat Spill?            

  • Previous Accident:   Pick a Date   
    Nature of Accident:      
    Fatalities?         
    Injuries?         
    HazMat Spill?         

  • Previous Accident:   Pick a Date   
    Nature of Accident:      
    Fatalities?         
    Injuries?         
    HazMat Spill?         

  • Previous Accident:   Pick a Date   
    Nature of Accident:      
    Fatalities?         
    Injuries?         
    HazMat Spill?         

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  • Traffic Convictions or Forfeitures for the Past 3 Years (other than Parking Violations)...

  • Location:                  
    Date:   Pick a Date   
    Charge:      
    Penalty:      

  • Location:                  
    Date:   Pick a Date   
    Charge:      
    Penalty:      

  • Location:                  
    Date:   Pick a Date   
    Charge:      
    Penalty:      

  • Location:                  
    Date:   Pick a Date   
    Charge:      
    Penalty:      

  • CDL's or Permits held in the past 3 Years...

  • State:* 
    License #:      
    Class:            
    Endorsements:   (H or X )        
    Restrictions:               
    Expires:   Pick a Date   

  • State: 
    License #:      
    Class:            
    Endorsements:   (H or X )        
    Restrictions:               
    Expires:   Pick a Date   

  • Have you ever been denied a license, permit, or privilege to operate a motor vehicle?            
    Has any license, permit, or privilage ever been suspended or revoked?         
    If you answered "Yes" to either of the above, please explain:   *   

  •  
  • Driver License Requirements:

    Driver Requirements:  Parts 383 & 391 of the Federal Motor Carrier Safety Regulations contain certain driver licensing requrements that you, as a driver for Partners, Corp., and given the Requrements and Expections above, must comply with, including the following:

    Possess Only One License:  Each commercial vehicle driver may not possess more than one motor vehicle operator's license.

    Notification of License Suspension, Revocation, or Cancellation:  Section 391.15(b)(2) and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT Business Day of any revocation or suspension of your Driver's License.  In addition, Section 383.31 requires that any time you are convicted of violation a state or local traffic law (other than parking), you must report it within 30 days to: 1) your employing motor carrier, and 2) the state that issued your license (if the violation occurs in a state other than the one which issued your license).  The notification to both the employer and the state must be in writing.

    CDL Domicile Requirements:  Section 383.23(a)(2) requires that your commecial driver's license be issued by your legal state of domicile, where you have your true, fixed, and permanenet home and principlal residence and to which you have the intention of returning whenver you are absent.  If you establish a new domicile in another state, you must apply to transfer your CDL within 30 days.

  • Partners, Corp. - Driver - Job Requirements & Expectations

    • Deliver goods while operating a tractor-trailer truck, sometimes over intercity routes, or spanning several states.
    • Occasionally assist with the loading and/or unloading of cargo.
    • Keep accurate records of amount, type, times, and temperatures of cargo being delivered.
    • Accept dispatch in written (hardcopy and/or digital) and/or verbal form for new pickups/deliveries.
    • Safely drive long distances.
    • Safely, and within company directives, fuel and clean truck and/or trailer when necessary.
    • Report to a dispatcher any incidents encountered on the road, upon loading or unloading, or any incident while off-duty, which may prevent you from safely or completely being able to fulfill any responsiblities while under dispatch.
    • Monitor road conditions and watch for traffic congestion in order to ensure safe and timely transit.
    • Follow all applicable traffic laws at all times.
    • Compliance with the Best Practices for Safety Standards at all times, including use of the seatbelt whenever the CMV is in motion, always using the 3-point contact rule when entering or exiting, and appropriate and correct use of any/all available safety equipment.
    • Inspect both the tractor and trailer before, during, and after use, and record and report any defects or damages.
    • Follow accident procedures if an accident occurs.
    • Utilize and maintain all record keeping equipment (Electronic Logging Device).
    • Report all mechanical problems to the appropriate personnel, serious issues to be reported immediately.
    • Keep truck, and all associated company equpment, clean, professional in appearance, and in good working order.
    • Plan routes using maps, online resources, dispatcher information, or any other approriate industry resource in order to maximize efficiency.
    • Deliver goods to client intact and on time.
    • Take rest periods during trip.
    • Take special precautions while driving when necessary.
    • Utilize communication resources effectively to receive and dispense appropriate information with Partners, Corp.
    • Maintain all credentials required for operation of a Commercial Motor Vehicle within the laws as defined by the DOT, FHWA, and FMCSA.
  • Is there any reason you might be unable to perform any of the functions of the job for which you are applying (as described above)?      *      
    If "Yes", explain if you wish:   *   

  • Partners, Corp. Authorizations

    • I authorize Partners, Corp. 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 Partners, Corp.
    • I undertand 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 the previous employers to re-send the corrected information to Partners, Corp.;
      • 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.
  • General Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse

     

    I hereby provide consent to Partners, Corp. to conduct a query of the FMCSA Commercial Driver’s License Drug and Alcohol Clearinghouse (Clearinghouse) to determine whether drug or alcohol violation information about me exists in the Clearinghouse. This consent is being given knowing that Partners, Corp. will conduct such queries over the duration of my employment at intervals and with the regularity required by the Federal Motor Carrier Safety Administration (FMCSA).

    I understand that if the query conducted by Partners, Corp. indicates that drug or alcohol violation information about me exists in the Clearinghouse, FMCSA will not disclose that information to Partners, Corp. without first obtaining additional specific consent from me.

    I further understand that if I refuse to provide consent for Partners, Corp. to conduct a query of the Clearinghouse, Partners, Corp. must prohibit me from performing safety-sensitive functions, including driving a commercial motor vehicle, as required by FMCSA’s drug and alcohol program regulations.

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