FIELD STAFF-DRIVER (NON-CDL) Employment Application

FIELD STAFF-DRIVER (NON-CDL) Employment Application

Please answer all questions completely. Incomplete applications will not be accepted.
Position & Applicant Information
Applicant Last Name
Applicant First Name
Middle Initial
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Apt #
Main Phone
Please enter a valid phone number.Format: (000) 000-0000.
Mobile Phone
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone
Please enter a valid phone number.Format: (000) 000-0000.
E-mail Address
example@example.com
Relatives & Emergency Contacts
Are any relatives employed by CrewZers?
Relationship to you
Relative Name
Relative Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name(s)
Emergency Contact Relationship to you
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Eligibility & Background
Legally authorized to work in the United States?
Within the past three (3) years, have you tested positive or refused to take a drug or alcohol test required by an employer for a position involving driving, equipment operation, or other safety-sensitive duties?
If yes to the above, Employer’s Name
Date of POSITIVE or REFUSED TO TEST

MonthDayYear
Date
In accordance with applicable law, have you been convicted of a Felony or a Misdemeanor, pled guilty or been released from prison within the past seven (7) years?
If YES, indicate the dates and nature of offenses (a conviction will not necessarily bar you from employment)
Are you at least 18 years old?
Able to reliably report to assigned work locations as required?
Are you willing to work SEASONAL ON-CALL, including Nights and Weekends for indefinite periods
If no, describe any limitations
If offered employment, when would you be available to work?
Essential functions include basic tasks such as Set Up and Take-Down of Tents/Portable Shelters & Equipment, site preparation, maintenance of equipment (cleaning, sweeping, mopping), maintaining equipment logs, and performing equipment duties in a mobile environment. Some job positions will require Heavy Lifting, Physical Strength, Hand-Eye Coordination & Endurance. Jobs may include setting up/cleaning mobile shower units, mobile hand wash units and/or mobile laundry detail. This position include safe operation of commercial motor vehicles for the transportation of equipment and materials; completion of required inspections and logs; and compliance with all applicable DOT regulations and company policies. Must be able to concentrate on tasks, follow instructions, & work well with others.

Field Work & Schedule Acknowledgment
This position may require extended travel, long hours (including 8–14+ hour shifts), outdoor work in varying weather conditions, and physically demanding labor. Work schedules may be unpredictable and based on emergency response needs.

Employment with Crewzers is contingent upon successful completion of all pre-employment requirements, which may include drug and/or alcohol testing, background check, driving record review, inquiry with past employers, Clearinghouse consent, and completion of required orientation and training. Position is Seasonal/On-Call.
Are you willing and able to meet the job requirements and working conditions described in this application?
Are you able to perform Essential Functions of the job (see above) with or without reasonable accommodation?
If no, list required accommodations
CrewZers provides equal employment opportunities to all applicants and employees without regard to race, color, religion, gender, National Origin, age, disability, or veteran status.
Education & Training
High School Name
High School City
High School State
High School Graduate or GED
College or University Name
College or University Location (City and State)
College or University Dates From

MonthDayYear
Date
College or University Dates To

MonthDayYear
Date
College or University Graduate
Degree Title
Degree Date

MonthDayYear
Date
Major
Credit Hours
Other Training 1 Dates From / To
Other Training 2 Dates From / To
Driver's License
State
License Number
Expiration Date

MonthDayYear
Date
Have you had a Driver License in another state in the last five (5) years (list all that apply)?
Issuing State - 1
Dates From - 1

MonthDayYear
Date
Dates To - 1

MonthDayYear
Date
Issuing State - 2
Dates From - 2

MonthDayYear
Date
Dates To - 2

MonthDayYear
Date
Licenses & Certifications
Other valid Professional Licenses or Certificates
Issuing State
Registration #
Expiration Date

MonthDayYear
Date
Driving Record – Suspensions & Serious Offenses
In the last five (5) years, has your driver’s license been revoked or suspended?
If yes, provide the date(s) and reason(s)
In the last five (5) years, have you been cited for Negligent Driving, DWI or DUI, Reckless Driving or Open Container?
If yes, provide the date(s) and offense(s)
Traffic Violations
List all the traffic code violations you have had in the United States within the last five (5) years, starting with the most recent violation. If you have speeding tickets, state how fast you were going and the posted speed limit.
Have you had any traffic code violations in the United States within the last five (5) years
Violation 1 Date (Month/Year)

MonthDayYear
Date
Violation 1 Reason for Citation
Violation 1 Speeding Ticket (Speed & Limit)
Violation 1 Location (City, State)
Violation 1 Has ticket been paid?
Violation 1 Was license suspended or revoked?
Violation 2 Date (Month/Year)

MonthDayYear
Date
Violation 2 Reason for Citation
Violation 2 Speeding Ticket (Speed & Limit)
Violation 2 Location (City, State)
Violation 2 Has ticket been paid?
Violation 2 Was license suspended or revoked?
Violation 3 Date (Month/Year)

MonthDayYear
Date
Violation 3 Reason for Citation
Violation 3 Speeding Ticket (Speed & Limit)
Violation 3 Location (City, State)
Violation 3 Has ticket been paid?
Violation 3 Was license suspended or revoked?
Violation 4 Date (Month/Year)

MonthDayYear
Date
Violation 4 Reason for Citation
Violation 4 Speeding Ticket (Speed & Limit)
Violation 4 Location (City, State)
Violation 4 Has ticket been paid?
Violation 4 Was license suspended or revoked?
Accidents
List all accidents in the last five (5) years, including employment-related accidents.
Have you had any accidents in the last five (5) years
Accident 1
Date (Month/Year)

MonthDayYear
Date
Brief Description
Damage (Approximate Dollar Amount)
Injuries
Were you given a traffic citation?
Accident 2
Date (Month/Year)

MonthDayYear
Date
Brief Description
Damage (Approximate Dollar Amount)
Injuries
Were you given a traffic citation?
Accident 3
Date (Month/Year)

MonthDayYear
Date
Brief Description
Damage (Approximate Dollar Amount)
Injuries
Were you given a traffic citation?
Accident 4
Date (Month/Year)

MonthDayYear
Date
Brief Description
Damage (Approximate Dollar Amount)
Injuries
Were you given a traffic citation?
Accident 5
Date (Month/Year)

MonthDayYear
Date
Brief Description
Damage (Approximate Dollar Amount)
Injuries
Were you given a traffic citation?
Skills
List any skills that may be useful for the job. Enter the number of years of experience, and select the number of stars that correspond to your ability for each particular skill (1 represents POOR ability, while 5 represents EXCEPTIONAL ability)
Skill 1
Years of Experience 1
Rating 1
Skill 2
Years of Experience 2
Rating 2
Skill 3
Years of Experience 3
Rating 3
Employment History
This section must be completed in detail.
- List your work experience for the last 10 years, starting with your most recent job.
- A resume will not substitute for a completed application form.
- Under “duties and responsibilities” describe your job in detail.
- If you have had more than ten (10) jobs or wish to add more detail to the “duties” section, complete a separate sheet in the same format and email to employment@crewzers.com.
- If you have been terminated from any previous job(s), please state the specific reason(s) why
Job 1 - Dates From

MonthDayYear
Date
Job 1 - Dates To

MonthDayYear
Date
Job 1 - Name of Employer
Job 1 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 1 - Ending Salary
Job 1 - Your Title
Job 1 - Supervisor Name & Title
Job 1 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 1 - Number of Work Hours per Week
Job 1 - May we contact this employer?
Job 1 - Duties and Responsibilities
Job 1 - Reason for leaving/wishing to leave
Job 2 - Dates From

MonthDayYear
Date
Job 2 - Dates To

MonthDayYear
Date
Job 2 - Name of Employer
Job 2 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 2 - Ending Salary
Job 2 - Your Title
Job 2 - Supervisor Name & Title
Job 2 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 2 - Number of Work Hours per Week
Job 2 - May we contact this employer?
Job 2 - Duties and Responsibilities
Job 2 - Reason for leaving/wishing to leave
Job 3 - Dates From

MonthDayYear
Date
Job 3 - Dates To

MonthDayYear
Date
Job 3 - Name of Employer
Job 3 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 3 - Ending Salary
Job 3 - Your Title
Job 3 - Supervisor Name & Title
Job 3 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 3 - Number of Work Hours per Week
Job 3 - May we contact this employer?
Job 3 - Duties and Responsibilities
Job 3 - Reason for leaving/wishing to leave
Job 4 - Dates From

MonthDayYear
Date
Job 4 - Dates To

MonthDayYear
Date
Job 4 - Name of Employer
Job 4 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 4 - Ending Salary
Job 4 - Your Title
Job 4 - Supervisor Name & Title
Job 4 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 4 - Number of Work Hours per Week
Job 4 - May we contact this employer?
Job 4 - Duties and Responsibilities
Job 4 - Reason for leaving/wishing to leave
Job 5 - Dates From

MonthDayYear
Date
Job 5 - Dates To

MonthDayYear
Date
Job 5 - Name of Employer
Job 5 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 5 - Ending Salary
Job 5 - Your Title
Job 5 - Supervisor Name & Title
Job 5 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 5 - Number of Work Hours per Week
Job 5 - May we contact this employer?
Job 5 - Duties and Responsibilities
Job 5 - Reason for leaving/wishing to leave
Job 6 - Dates From

MonthDayYear
Date
Job 6 - Dates To

MonthDayYear
Date
Job 6 - Name of Employer
Job 6 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 6 - Ending Salary
Job 6 - Your Title
Job 6 - Supervisor Name & Title
Job 6 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 6 - Number of Work Hours per Week
Job 6 - May we contact this employer?
Job 6 - Duties and Responsibilities
Job 6 - Reason for leaving/wishing to leave
Job 7 - Dates From

MonthDayYear
Date
Job 7 - Dates To

MonthDayYear
Date
Job 7 - Name of Employer
Job 7 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 7 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 7 - Ending Salary
Job 7 - Your Title
Job 7 - Supervisor Name & Title
Job 7 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 7 - Number of Work Hours per Week
Job 7 - May we contact this employer?
Job 7 - Duties and Responsibilities
Job 7 - Reason for leaving/wishing to leave
Job 8 - Dates From

MonthDayYear
Date
Job 8 - Dates To

MonthDayYear
Date
Job 8 - Name of Employer
Job 8 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 8 - Ending Salary
Job 8 - Your Title
Job 8 - Supervisor Name & Title
Job 8 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 8 - Number of Work Hours per Week
Job 8 - May we contact this employer?
Job 8 - Duties and Responsibilities
Job 8 - Reason for leaving/wishing to leave
Job 9 - Dates From

MonthDayYear
Date
Job 9 - Dates To

MonthDayYear
Date
Job 9 - Name of Employer
Job 9 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 9 - Ending Salary
Job 9 - Your Title
Job 9 - Supervisor Name & Title
Job 9 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 9 - Number of Work Hours per Week
Job 9 - May we contact this employer?
Job 9 - Duties and Responsibilities
Job 9 - Reason for leaving/wishing to leave
Job 10 - Dates From

MonthDayYear
Date
Job 10 - Dates To

MonthDayYear
Date
Job 10 - Name of Employer
Job 10 - Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Job 10 - Ending Salary
Job 10 - Your Title
Job 10 - Supervisor Name & Title
Job 10 - Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job 10 - Number of Work Hours per Week
Job 10 - May we contact this employer?
Job 10 - Duties and Responsibilities
Job 10 - Reason for leaving/wishing to leave
Give dates and explain all periods of UNEMPLOYMENT during the past 10 years (if none, type "None":
Applicant Certification & Signature
I acknowledge that submittal of my application packet will not automatically constitute an offer of employment.

I certify that I have completed this application and that all information contained within it is true and complete to the best of my knowledge. I understand that any misrepresentation or material omission of fact on this or any other document required by Crewzers will constitute grounds for Rejection of my Application.

I further understand that an employment offer will be subject to successful completion and results for drug and alcohol background check, drug testing, reference checks, driver’s record evaluation, and criminal history checks. Having applied for employment with Crewzers, I hereby agree and give my consent that any person, firm or organization listed herein is authorized to furnish Crewzers with reference material concerning my character, past employment or any other information requested.

I agree to take any post-offer employment physical, drug and/or alcohol tests, as are required. I agree to wear personal protective clothing and/or devices as required and to comply with safety rules. I authorize Crewzers to obtain my employment and non-employment driving record, including all State Department of Licensing Actions that have occurred under the driver’s license I now hold, the driver licenses I have held, or the driver licenses I may obtain in the future. I further agree to any other conditions of employment described in the application materials.

I authorize CrewZers Fire Crew Transport, Inc. to make such investigations and inquiries of my employment and medical history and other related matters as may be necessary to make an employment decision. I hereby release my employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of my employment, I understand that false or misleading information given in my application or interview(s) may result in my dismissal. I understand that I am required to abide by all rules and regulations of CrewZers, USDOT, USFS, BLM, BIA, DOD, and any other contracting agencies.
Print Name

First NameLast Name
Applicant Signature
Application Date

MonthDayYear
Date
Should be Empty:

FIELD STAFF-DRIVER (NON-CDL) Employment Application

Position & Applicant Information

Relatives & Emergency Contacts

Eligibility & Background

Education & Training

Driver's License

Licenses & Certifications

Driving Record – Suspensions & Serious Offenses

Traffic Violations

Accidents

Skills

Employment History

Applicant Certification & Signature