Job Application Form

Employment History Information
Work History: Current and previous 2 employers (most current employer listed first)
Most Recent Employer Name

First NameLast Name
City, State
Position Held
Start Date

MonthDayYear
Date Finished

MonthDayYear
Employer phone

Area CodePhone Number
Supervisor name

First NameLast Name
Describe your duties:
Reason for leaving
NEXT EMPLOYER
Employer Name

First NameLast Name
City, State
Position Held
Start Date

MonthDayYear
Date Finished

MonthDayYear
Employer phone

Area CodePhone Number
Supervisor name

First NameLast Name
Describe your duties:
Reason for leaving
NEXT EMPLOYER
Employer Name

First NameLast Name
City, State
Position Held
Start date

MonthDayYear
Date Finished

MonthDayYear
Employer phone

Area CodePhone Number
Supervisor name

First NameLast Name
Describe your duties:
Reason for leaving

Additional Information
Have you ever been convicted of or have a pending DUI / DWI?
If YES, when?
Have you ever been employed under a name other than the name used on this application?*

YesNo
If Yes Please Explain

EDUCATION INFORMATION
Highest Grade Completed
College
Trade school:
Last school attended:
City
Date
Name & City/State of High School*
You should hire me because...*
CDL-ST:
License Number
Class
Exp. Date
Have you ever been denied a license, permit of privilege to operate a motor vehicle:
Has any license, permit or privilege ever been suspended or revoked?
Have you ever been disqualified for violations of the FMCSR?
If you answered YES to any of the above, give details

Class of Equipment Straight Truck
Types of Equipment
From
To
Approx. Miles
Tractor Trailer
Types of Equipment
From
To
Approx. Miles
Twin Trailers
Types of Equipment
From
To
Approx. Miles
Other
Types of Equipment
From
To
Approx. Miles
List states operated in during the past five (5) years
List special courses or training that will help you as a driver:
List safe driving awards held and who presented the awards:
DRIVING EXPERIENCE QUALIFICATION AND INFORMATION
Have you ever been bonded?
Name of company
Have you ever been convicted of a felony
If YES, please explain in detail. Conviction of a crime is not an automatic bar to employment.All circumstances will be considered
ACCIDENT REVIEW FOR PAST THREE (3) YEARS
Date, Nature,Injuries, Remarks
TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST THREE (3) YEARS
Dates, Locations, Charges, Penalties

Other comments that you would like to add to add that you think would help in our decision for hiring:
DRUG AND ALCOHOL TESTING
Pursuant to changes effective August 1, 2001 in Part of the FMCSR, this section is being added to the driver application and should be completed by each applicant. These changes require each motor carrier to inquire prospective drivers the information in the questions below.Have you, the applicant, had a positive alcohol or drug test result or refused to take a DOT drug or alcohol pre
-employment testwithin the past three (3) years:
Yes/No?
If YES, name the motor carrier:
Address:
City
State
Phone
In addition, if the
answer to the above question is YES, please list the name and contact information for the Substance Abuse
Professional (SAP) who completed your evaluation.
Name of SAP:
Address:
City
State
Phone
Please supply prospective
employer with your driver’s license, social security card and TWIC card upon applying for a position.

APPLICANT MUST READ AND SIGN
I certify that I have read and understand all of
this employment application. It is agreed and understood that the
employer or its agents may investigate my background to
ascertain anyand all information of concern to my
employment history, whether same is of record or not. I hereby release Sindle Trucking, LLC, its officers, employees, agents, directors, affiliates and attorneys and any other persons named herein from all liability for any
damages on account of furnishing such information. I understand that as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks that are pertinent to the job. I also
understand that if offered a job, it may be conditioned on the result of physical examination and drug test. It is also agreed and understood that under the Fair Credit Reporting Act, public law91-508, I have been told that this investigation may include an investigative consumer report, including information regarding my character, general reputation, personal characteristic and mood. I agree to furnish such additional information and complete such examinations as may
be required to complete my employment file. I also understand that misrepresentation of or omission of information of facts may result in my rejection or dismissal. It is agreed and understood that this application for employment in no way obligates the employer to employ the applicant.
If hired, I agree and abide by all the results and policies of the employer.
This certifies that this application was completed by me, and that all entries on and information in it are true and correct to the best of my knowledge. This also certifies that I have received a copy of the job description and company policies and all questions have been answered to my satisfaction
Applicants' Signature and Date:
Choose ONE:*

I ACCEPTI DO NOT accept

Should be Empty: