HJSS Driver & O/O Application Form

Haulin' Jack Shipping Service, Inc. Driver & Owner Operator Application

Please enter your Personal Information. When you have finished, select "Next" to continue to the next section of the application.
Full Name*

First NameMiddle NameLast Name
Company Name (if applicable)
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email Address*

Confirmation Emailexample@example.com
EIN# (if applicable)
(Numbers Only)
SS#*
(Numbers Only)
Position Applying For:*
Date Available for Work*

MonthDayYear
Date
Areas of Interest:*
Do you have your own trailer?*

Yes, I have my ownNo, I will need to leaseN/A
Do you have your own plates?*

Yes, I have my ownNo, I will need platesN/A
Are you willing to submit a drug test as a requirement for employment?*
Will you work overtime or shift work? You may be required to drive in a slip-seat arrangement which requires that you drive for up to 11 hours per day and work to a maximum of 70 hours per week. This DOT rule mandates that a driver must have at least 24 hours off- duty before restarting. *
Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Previous Address (if different the last 3 years)

Street Address

Street Address Line 2

CityState

Zip Code
From

Month Year Years

TO
until
Month Year Years
Only U.S. citizens or those individuals who have a legal right to work in the U.S. are eligible for employment or leasing. Can you, upon employment or leasing, provide genuine documentation establishing your identity and eligibility to be legally employed in the United States? *
How did you hear about our Company?
If Referred. By who?

Credential Upload

You can upload a file from your computer, smart phone, or tablet. Choose "Next" to continue.
Upload Drivers License (FRONT)*

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Upload Drivers License (BACK)*

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Upload Medical Certificate*

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Haulin' Jack Shipping Service, Inc. Driver & Owner Operator Application

Credential Upload

Employment History