Driver Application Form

Driver Application Form

Apply to drive with Revitalize Logistics. Please complete this form to determine your eligibility.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you at least 21 years old?
Are you legally authorized to work in the United States?
Which type of driver position are you applying for?
Do you have a valid driver’s license for the position you are applying for?
How many years of professional driving experience do you have?
Have you ever been denied a drivers license, permit, or privilege to operate a motor vehicle?
If yes please explain.
Has any license, permit, or privilege ever been suspended or revoked?
If yes please explain,
Do you have any moving violations or accidents in the past 3 years?
If yes please list Date and Nature of Accident
Do you have any endorsements? If yes please list below.
Do you consent to a background check?
Do you consent to a drug test?
Please list your last 3 employers. Name, Address, Date, Phone, and Reson for leaving
Please list your current endorsements or certifications (if any)
Upload your drivers license

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Upload your resume (Optional)

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Signature
Should be Empty: