Truck Driver Application

License Information
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!
You are applying for a driving job with American Concerete Washouts.

This position requires a minimum of a Class B CDL, 3 years minimum verdified CDL driving experience, and a Tanker endorsement.

This is a Roll Off and Vacuum truck position, Hazmat is not required.

Hours are Monday-Friday with a start time of 6:00 a.m.

Thank you for allowing us to help you with your career search!
Location Applying For*

Dallas TexasSacramento CaliforniaSanDiego California
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 25 years of age or older?*

YesNo
Have you held a VALID US CDL 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
Tanker Endorsement is required. Please check CDL Endorsements*

NoneTankerDoubles/TriplesHazmatX EndorsementTWIC
Please list any licenses held in other states for the previous 5 years, include license numbers if you can.*
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
EMPLOYMENT HISTORY
Work History: Please list current, or most recent employment first.

Previos 7 years work history incluiding all periods of unemployment required.
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
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
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
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
If you need additional space for past employment, please enter it here and include ALL information previously asked for.
Additional Information
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
Additional Information
References: Please list name, address, phone and years known.
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*
Emergency contact information
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
By signing I agree I have read the above statements
Should be Empty:

License Information

EMPLOYMENT HISTORY

Additional Information

Additional Information

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

Emergency contact information