JDEE Transport Services, LLC (855) 605-5333
INTAKE QUESTIONNAIRE - WE HIRE DRIVERS ACROSS THE LOWER 48 STATES
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
TYPES OF POSITIONS DRIVER WILL ACCEPT:
LOCAL
REGIONAL
OTR
LEASE PURCHASE
TRAINEE (LESS THAN 3 MONTHS)
STUDENT (ATTEND SCHOOL TO OBTAIN CDL A)
TRAILER EXPERIENCE
40ft. - 45ft.
53ft.
DRY VAN
REEFER
FLATBED
TANKER
OTHER
DO YOU HAVE TARPING EXPERIENCE?
YES
NO
CHECK ALL CURRENT ENDORSEMENTS THAT APPLY:
TANKER
HAZMAT
DBLS/TRPLS
TWIC CARD
HOW MUCH VERIFIABLE CDL A EXPERIENCE DO YOU HAVE?
DO YOU HAVE ANY AUTO RESTRICTIONS?
YES
NO
IF YOU HAVE EVER HAD ANY MISDEAMEANORS / FELONIES, EXPLAIN BELOW WITH DATES. IF NOT, WRITE "NONE".
IF YOU HAVE EVER HAD ANY DUI'S OR DWI'S EXPLAIN BELOW WITH DATES. IF NOT, WRITE "NONE".
HAVE YOU HAD ANY REFUSED OR FAILED DRUG TEST?
YES
NO
HAVE YOU EVER BEEN TERMINATED?
YES
NO
HAS YOU LICENSE EVER BEEN SUSPENDED OR REVOKED? IF SO, WRITE MONTH AND YEAR. IF NOT, WRITE "NO".
HAVE YOU HAD ANY ACCIDENTS IN THE PAST 7 YEARS? IF SO, WRITE MONTH AND YEAR. IF NOT, WRITE "NO".
BEST TIME AND METHOD TO CONTACT.
DO YOU AGREE TO BE CONTACTED TEXT MESSAGE REGARDING EMPLOYMENT?
YES
NO
PLEASE DO NOT ANSWER QUESTIONS BELOW
"FOR OFFICE USE ONLY"
DATE AND POSITION THAT QUALIFIES CANDIDATE
RESULTS OF INTAKE/INTERVIEW
INTAKE AGENT NAME
blanks
DATE
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Math Challenge
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