SFD Truck Driver Application

DRIVER APPLICATION

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.

Please give complete answers to ALL questions - Incomplete answers will only slow, or stall the application and our goal is to get you hired quickly. Thank you Drivers - No matter WHO you drive for!

Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Were you at this address 3 years or more

YesNo

Please list prior 3 year addresses here and please be complete

Date of Birth*

MonthDayYear

Phone Number*

Area CodePhone Number

E-mail*

Have you ever been known by any other name?

YesNo

Please list name

Explain ie; maiden name, name change

If hired, can you furnish proof you are eligible to work in the U.S.?*

YesNo

Are you at least 21 years of age or older?*

YesNo

Position Applying For (OTR/Shuttle)

Have you held a VALID US license for the past 36 months?*

YesNo

License Class*

State of Issue*

License expiration date*

MonthDayYear

Expiration date of DOT physical card

MonthDayYear

CDL Endorsements*

Hazmat expiration date

MonthDayYear

TWIC expiration date

MonthDayYear

Please list any licenses held in other states for the previous 5 years.

Have you been to truck driving school?

YesNo

School information

School Name

Dates of attendance

CityState / Province

GPA if availableCountry

School phone number

Area CodePhone Number

Did you graduate?

YesNo

Must include past 10 years of employment.

Have you worked for Specialty Foods Distribution in the past?*

YesNo

Start Date

MonthDayYear

End Date

MonthDayYear

Please list current, or most recent employment first.

Start date*

MonthDayYear

Ending date*

MonthDayYear

Employer Name*

City, State*

Employer phone*

Area CodePhone Number

Position Held*

Reason for leaving*

Is this your current employer?*

YesNo

May we contact this employer at this time?*

YesNo

Was this a driving position?

YesNo

Type of truck

Number of states driven

NEXT EMPLOYER

Start date

MonthDayYear

Ending date

MonthDayYear

Employer Name

City, State

Position Held

Reason for leaving

Employer phone

Area CodePhone Number

Was this a driving position?

YesNo

Type of truck

Number of states driven

NEXT EMPLOYER

Starting date

MonthDayYear

Ending date

MonthDayYear

Employer Name

City, State

Position Held

Employer phone

Area CodePhone Number

Reason for leaving

Was this a driving position

YesNo

Type of truck driven

Number of states driven

NEXT EMPLOYER

Start Date

MonthDayYear

End Date

MonthDayYear

Employer Name

City and State

Position

Employer Phone

Area CodePhone Number

Reason for leaving

Was this a driving position

YesNo

Type of truck driven

Number of states driven

NEXT EMPLOYER

Start Date

MonthDayYear

End Date

MonthDayYear

Employer Name

City and State

Position

Employer Phone

Area CodePhone Number

Reason for leaving

Was this a driving position

YesNo

Type of truck driven

Number of states driven

NEXT EMPLOYER

Start Date

MonthDayYear

End Date

MonthDayYear

Employer Name

City and State

Position

Employer Phone

Area CodePhone Number

Reason for leaving

Was this a driving position

YesNo

Type of truck driven

Number of states driven

If you need additional space for 10 years of past employment , please enter it here and include ALL information previously asked for.

Have you had any moving violations in the last 5 years?*

YesNo

If yes, please list City, County and State, month, year and nature of offense and any fines involved

Please list miles over limit for speeding

Has your license suspended ever been suspended?*

YesNo

If yes, please give date and length of supension. List reason why, city, county and state

List all details asked for

Have you had any accidents in the last 5 years?*

YesNo

If yes, please give date, explaination, city, county and state and if you received ticket/fine (amount)

Have you ever had a DUI, DWI, or OVI?*

YesNo

If yes, please list date of offense, jail time, fine and or suspension time.

We must have complete information to satisfy isusance carrier requirements.

Have you ever been convicted of a felony?*

YesNo

If yes, please give date and nature of offense, city, county, state and any fines and time served

Please list everything asked for per insurance requirements.

Have you ever been convicted of a misdemeanor?*

YesNo

If yes, please list date and nature of offense, city, county and state. also jail time, probation, or fines

Please list everything asked for per insurance requirements.

EDUCATION

Name & City/State of High School

Did you graduate/equivalent?

YesNo

Name & City/State of College

Did you graduate?

YesNo

REFERRAL INFORMATION

Were you referred by someone to SFD?

YesNo

If yes above, who referred you to SFD?

Official Disclosure Statement:

I certify that I personally completed this application and that all of the information is true and correct to the best of my knowledge. Authorization to Release Records I authorize the carrier subscribers indicated on this application to do a complete background investigation in accordance with state and federal laws. I authorize my previous employers to release any information requested by these carrier subscribers and hold them harmless of all liability from the release of said information. I hereby request and authorize to cause to be conducted, at any time, an investigation of my background for employment purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reflect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information. I have completed this application of my own free will and hold harmless of all liability all companies, agents and associated parties for the use of this application.

I understand that information I provide regarding current and/or previous employers may be used, and those empoyer(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 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.

Choose ONE:*

I ACCEPTI DO NOT accept

By signing I certify 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.*

General Information

License Information

EMPLOYMENT HISTORY

Additional Information

Additional Information