JFI Driver Application

JFI DRIVER APPLICATION

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!

If you have questions about this application, please contact Troy Bauder at 605-764-7366

Position/Lane Applying 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*

example@example.com

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 23 years of age or older?*

YesNo

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

YesNo

License Class*

License Number*

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, include license numbers if you can.

Were you ever in the military?*

YesNo

Branch of service

Please list Dates of enlisment

Enlist date - Discharge date

Did you receive an honorable discharge?

YesNoOther

Do you have, or can you obtain your DD214?

YesNoI can obtain one

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

Work History: 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

Type of trailer

Trailer length

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

Type of trailer

Trailer length

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

Type of trailer

Trailer length

Number of states driven

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

Type of trailer

Trailer length

Number of states driven

If you need additional space for 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 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 isurance 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

Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Number of years known

Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Number of years known

Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Relationship to you*

Phone Number*

Area CodePhone Number

HIGH SCHOOL

Name & City/State of High School

Did you graduate?

YesNo

To Be Read and Signed By Applicant

JFI is an equal opportunity employer. JFI does not discriminate in employment on account of&#13;&#10;race, color, religion, national origin, citizenship status, ancestry, age, sex, gender, sexual&#13;&#10;orientation, marital status, physical or mental disability, military status or unfavorable discharge&#13;&#10;from military service. I understand that neither the completion of this application nor any other&#13;&#10;part of my consideration for employment an obligation for JFI to hire me. If I am hired, I&#13;&#10;understand that either JFI or I can terminate my employment at any time and for any reason,&#13;&#10;with or without cause and without prior notice. I understand that no representative of JFI has&#13;&#10;the authority to make any assurance to the contrary. It is agreed and understood that the motor&#13;&#10;carrier or its agents may investigate the applicant’s background to ascertain any and all&#13;&#10;information of concern to the applicant’s record, whether same is of record or not, and the&#13;&#10;applicant releases employers and persons named herein from all liability for any damages on&#13;&#10;account of his furnishing such information. It is also agreed and understood that under the Fair&#13;&#10;Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an&#13;&#10;investigating Consumer Report, including information regarding my character, general&#13;&#10;reputation, personal characteristics, and mode of living. I agree to furnish such additional&#13;&#10;information and complete such examinations as may be required to complete my qualification&#13;&#10;file. It is agreed and understood that if qualified and hired, I may be on a probationary period&#13;&#10;during which time I may be disqualified without recourse. I attest with my signature below that&#13;&#10;I have given JFI true and complete information on this application. No requested information&#13;&#10;has been concealed. I also understand that JFI may request to contact references provided for&#13;&#10;employment reference checks, and under consistent hiring practices, may require preemployment&#13;&#10;screening and background verification as a condition of employment upon any&#13;&#10;employment offer. If any information I have provided is untrue, or if I have concealed material&#13;&#10;information, I understand that this will constitute cause for the denial of employment or&#13;&#10;immediate dismissal.

Signature*

By signing I agree I have read the above statements

General Information

License Information

EMPLOYMENT HISTORY

Additional Information

Additional Information

References: Please list name, address, phone and years known.

Emergency contact information

Safety Performance Records Request Form

Request for Motor Vehicle Record