New Gen CDL Driver Application

New Gen CDL Driver Application
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth

MonthDayYear
Date
Last 4 of SSN#
Used for MVR/background screening only. Do not enter full SSN
CDL Experience
Position Applying For
Types of Equipment Driven

Straight TruckTractor-TrailerDoublesTankerFlatbedReefer
Years of Experience/ Trailer Experience
States You've Operated In?
Employment History
Company Name
Location (City, State)
Position
Start Date

MonthDayYear
End Date

MonthDayYear
Employer's Phone Number
Please enter a valid phone number.
Was this a DOT-regulated position?

YesNo
Reason for leaving?
Company Name
Location (City, State)
Position
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employer's Phone Number
Please enter a valid phone number.
Phone Number
Please enter a valid phone number.
Was this a DOT-regulated position?

YesNo
Reason for leaving?
Company Name
Location (City, State)
Position
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employer's Phone Number
Please enter a valid phone number.
Was this a DOT-regulated position?

YesNo
Reason for leaving?
Any moving violations in the past 3 years?

YesNo
If yes, list dates, charges, outcomes
Any accidents in the past 3 years?

YesNo
If yes, describe each (date, location, injuries)
Has your CDL ever been suspended or revoked?

YesNo
Any DUI or DWI convictions?

YesNo
Any felony or misdemeanor convictions?

YesNo
If yes, explain
Background Check Authorization
By submitting this application, I authorize New Gen Shipping and its agents to obtain background reports, motor vehicle records (MVR), previous employment verification, and other information necessary for DOT compliance.
Drug & Alcohol Testing Consent
I understand that I may be required to undergo pre-employment and random drug and alcohol testing as required by FMCSA and DOT regulations.
Do you agree to participate in DOT drug/alcohol testing?

YesNo
PSP/HireRight Authorize
I authorize New Gen Shipping to obtain my FMCSA Pre-Employment Screening Program (PSP) report, including my crash and inspection history, for employment evaluation purposes.
I authorize release of my PSP report

Yes
Signature

Powered by Jotform SignClear
Upload CDL

Allowed file types: .pdf, .jpg, .png. Max file size: 10MB
Cancelof
Upload Medical Card

Allowed file types: .pdf, .jpg, .png. Max file size: 10MB
Cancelof
Upload MVR (if available)

Allowed file types: .pdf, .jpg, .png. Max file size: 10MB
Cancelof
By signing below, I certify all information is true and complete to the best of my knowledge. I understand false or misleading information may result in disqualification or termination.*

Powered by Jotform SignClear
Should be Empty:

New Gen CDL Driver Application

CDL Experience

Employment History

Background Check Authorization

Drug & Alcohol Testing Consent

PSP/HireRight Authorize