GH Online Apply

116 NW Town Line Road, PO Box 239 Greenfield, IA 50849-0239

Applications are held for 90 days. Applications are considered for position without regard to race, creed, color, sex, religion, age (other than minimum requirements), disability, marital status, or national origin

Name*

Date of Application*

Date

Home Phone #*

Alt. Phone #

Position Applied For*

Current Address*

Previous Address

Have you ever failed or refused a pre-employment drug/alcohol test given by a company where you never accepted

NoYes

Have you worked for this company before?

YesNo

Do you have any relatives working for this company?

YesNo

Dates

Date

Name

Reason for leaving

Relationship

Name*

Supervisor*

Are you presently employed?*

YesNo

May we contact your current Employer?*

YesNo

Dates of Employment

From*

Date

To*

Date

Address

Telephone

City

State

Zip Code

Position Held

Equipment Driven

Driving Experience

Approximate Total Number of Miles Driven for this Employer

Rate of Pay

Reason For Leaving

QuitFiredLay offOther / Explain Circumstances

Were you subject to the Federal Motor Carrier Safety Regulations while employed by this employer?

YesNo

Was this a safety sensitive function as defined by the DOT, subject to alcohol & drug testing?

YesNo

Are you a U.S Citizen or otherwise lawfully authorized to work in this country?

YesNo

Have you ever been convicted of a felony?

YesNo

If Yes, WHEN? (A conviction records will not necessarily bar you from employment. Such factors as age and time of the offense, seriousness, and nature of the violation will be taken into account)

Is there any reason that you might be unable to perform the functions of the job, for which you have applied (i.e.: Truck Driver, [but not limited to] lifting, loading, unloading, minor maintenance, tarping and securement of loads, fueling, and driving)?

YesNo

Have you been convicted for driving while intoxicated or driving while under the influence of drugs within the last five (5) years?

YesNo

Are you familiar with the Federal Motor Carrier Safety Regulations?

YesNo

Have you ever been denied a bond?

YesNo

Do you have a valid CDL?

YesNo

Have you ever had your drivers' license suspended or revoked?

YesNo

Have you been convicted of any traffic violations in the past 4 years?

YesNo

Have you been involved in any accident in the past 4 years?

YesNo

Have you had any cargo claims in the past 4 years?

YesNo

College Degree

Check the following that apply:High School DiplomaG.E.D.None of These

Highest grade completed

Years of college

List any Truck Driving Schools you have attended, dates of completion, and other safety training

Have you served in the United States Armed Forces?

YesNo

I hearby acknowledge that prior to submitting this application, I have been informed that the information provided herein may be used to conduct current and previous employer’s references or any other individuals this Company considers necessary.

I hearby authorize my current and previous employers, references, and any other individuals contacted by this company to release any past or present information requested, including but not limited to past drug and alcohol test results, and I release all providers of said information from any liability stemming from release of same information.

In connection with my application for employment with this Company, I understand that I have the right to review, correct or rebut any information obtained from former employers requested by this Company

I understand that any false, misleading, or incomplete answers or statements shall be considered sufficient cause for denial or termination of employment and/or authorization to drive.

I understand that nothing contained in this application or in the granting of an interview or a road test is intended to create an employment contract between this Company and myself, for either employment, authorization to drive, or for the providing of any benefits. No promises regarding employment or authorization to drive have been made to me, and no such promises exist unless specifically made by this Company in writing. If an employment relationship is established, I understand that, as an employee at will, I have the right to terminate my employment at any time, and this Company has the same right.

I agree that any claim, charge or lawsuit related to my service with G&H Motor Freight Lines, Inc., or any of it's subsidiaries or affiliated companies must be filed no more that six (6) months after the date of the employment action that is the subject of the claim, charge or lawsuit. I hereby expressly and knowingly waive any limitations periods to the contrary.

First Name*

Last Name*

Applicants Signature*

Date*

Date

G&H Motor Freight Lines

Quick Online Application For Employment

PREVIOUS EMPLOYMENT

Dates of Employment

Please answer the following questions with a “YES” or “NO”

Driving Record / Licensing Information

Education

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