Bus Driver Application Form

FMCSR 391.21(d) COMPLIANCE
391.23 (d) The prospective motor carrier must investigate, at a minimum, the information listed in this paragraph from all previous employers of the applicant that employed the driver to operate a CMV within the previous three years. The investigation request must contain specific contact information on where the previous motor carrier employers should send the information requested.

(1) General driver identification and employment verification information.

(2) The data elements as specified in § 390.15 (b)(1) of this chapter for accidents involving the driver that occurred in the three-year period preceding the date of the employment application.

(i) Any accidents as defined by § 390.5 of this chapter. (ii) Any accidents the previous employer may wish to provide that are retained pursuant to § 390.15 (b)(2), or pursuant to the employer's internal policies for retaining more detailed minor accident information.

391.23 (e) In addition to the investigations required by paragraph (d) of this section, the prospective motor carrier employers must investigate the information listed below in this paragraph from all previous DOT regulated employers that employed the driver within the previous three years from the date of the employment application, in a safety sensitive function that required alcohol and controlled substance testing specified by 49 CFR part 40.

(1) Whether, within the previous three years, the driver had violated the alcohol and controlled substances prohibitions under subpart B of part 382 of this chapter, or 49 CFR part 40.

(2) Whether the driver failed to undertake or complete a rehabilitation program prescribed by a substance abuse professional (SAP) pursuant to § 382.605 of this chapter, or 49 CFR part 40, subpart O. If the previous employer does not know this information (e.g., an employer that terminated an employee who tested positive on a drug test), the prospective motor carrier must obtain documentation of the driver's successful completion of the SAP's referral directly from the driver.

(3) For a driver who had successfully completed a SAP's rehabilitation referral, and remained in the employ of the referring employer, information on whether the driver had the following testing violations subsequent to completion of a § 382.605 or 49 CFR part 40, subpart O referral:

(i) Alcohol tests with a result of 0.04 or higher alcohol concentration;

(ii) Verified positive drug tests;

(iii) Refusals to be tested (including verified adulterated or substituted drug test results).

391.23 (i)(1) The prospective employer must expressly notify drivers with Department of Transportation regulated employment during the preceding three years via the application form or other written document prior to any hiring decision that he or she has the following rights regarding the investigative information that will be provided to the prospective employer pursuant to paragraphs (d) and (e) of this section:

(i) The right to review information provided by previous employers;

(ii) The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer;

(iii) The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

(2) Drivers who have previous Department of Transportation regulated employment history in the preceding three years, and wish to review previous employer-provided investigative information must submit a written request to the prospective employer, which may be done at any time, including when applying, or as late as 30 days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), then the five-business days deadline will begin when the prospective employer receives the requested safety performance history information. If the driver has not arranged to pick up or receive the requested records within thirty (30) days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived his/her request to review the records.
I have been informed and understand that the information I am providing herein may be used, and my prior employers may be contacted, for the purpose of investigating my safety performance history information as required by paragraphs (d) and (e)of § 391.23.

I have further been informed of and understand my due process rights as specified in §391.23(i) regarding information received as a result of these investigations.

I understand that if I have made any misrepresentations on the application or failed to supply required information on this application, the company shall view this as an act of dishonesty and shall be sufficient ground for dismissal anytime.

I certify that I have read and fully understand all parts of this application, and that prior to signing, I was given the opportunity to ask questions and have those questions answered to my satisfaction.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
By electronically signing I agree I have read the above statements *
Manual Signature & Date (DO NOT FILL OUT)

Driver Notification and Release
FAIR CREDIT REPORTING ACT DISCLOSURE STATEMENT

In accordance with the provisions of Section 604(b)(2)(A) of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter I, of Public Law 104-208), You are being informed that reports verifying your previous employment, previous drug and alcohol test results, and your driving record may be obtained on you for employment purposes. Sections 382.413, 391.23, and 391.25 of the Federal Motor Carrier Safety Regulations require these reports.
We are an at-will employer and nothing in this application, or any other written document creates a contract for employment. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause.

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.

In connection with my application for employment (including contract for services if any) with you, I authorize you to conduct an investigation of all statements contained, and to obtain a consumer report. I understand that a consumer report, which may contain public record information, is being requested from HireRight or from a similar Agency or Company. This report may include the following types of information: names and dates of previous employers, reason for termination of employment, work experience, accidents, my credit and personal history etc. I further understand that such report may contain public record information concerning my driving record, workers' compensation claims, credit, bankruptcy proceeding, criminal records etc., from federal, state and other agencies which maintain such records; as well as information from HireRight or similar Agencies or Companies concerning previous driving record requests made by others from such state agencies, and state provided driving records.

I AUTHORIZE, WITHOUT RESERVATION, ANY PARTY OR AGENCY OR COMPANY CONTACTED BY EL PASO - LOS ANGELES LIMOUSINE EXPRESS, INC. (EPLA), HIRERIGHT OR A SIMILAR AGENCY OR COMPANY TO FURNISH THE ABOVE MENTIONED INFORMATION.

IF HIRED, I AUTHORIZE EPLA TO PROVIDE INFORMATION ABOUT ME RELATING TO THE PERIOD OF TIME I AM EMPLOYED BY EPLA AND PERTAINING TO THE STATUS OF MY SEPARATION OF EMPLOYMENT FROM EPLA TO HIRERIGHT, SIMILAR AGENCY OR COMPANY, OR FUTURE PROSPECTIVE EMPLOYER (SAID PROSPECTIVE EMPLOYER REQUESTING INFORMATION AS REQUIRED BY THE PERTINENT FEDERAL MOTOR CARRIER SAFETY REGULATIONS).

I have the right to make a request to HireRight, or similar Agency or Company upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of information; and the recipients of any reports on me which the Agency or Company has previously furnished within the two year period preceding my request. I hereby consent to your obtaining the above information from HireRight or similar Agency or Company and I understand and agree that such information which HireRight or similar Agency or Company had or obtains and my employment history with you if I am hired, will be supplied to and by HireRight or similar Agency or Company to other companies which subscribe to HireRight's or similar Agency’s or Company's services.
Type Full Name *
Social Security *
Date of Birth *

/ Month / Day Year
Driver License No. *
State Issued *
Expiration Date *

/ Month / Day Year
By electronically signing I agree I have read the above statements *
Manual Signature & Date (DO NOT FILL OUT)

MOTOR VEHICLE DRIVER’S CERTIFICATION

CERTIFICATION OF COMPLIANCE WITH DRIVER LICENSE REQUIREMENTS
MOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to every driver who operates in intrastate, interstate or foreign commerce and operates a vehicle weighing 26,001 pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding.

The requirements in Part 391 apply to every driver who operates in interstate commerce and operates a vehicle weighing 10,001 pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding.

DRIVER REQUIREMENTS Part 383 and 391 of the Federal Motor Carrier Safety Regulations contain some requirements that you as a driver must comply with. These requirements are in effect as of July 1987. They are as follows

As a commercial vehicle driver, you may not possess more than one license.

If you currently have more than one license, you should keep the license from your state of residence and return the additional licenses to the states that issued them. DESTROYING a license does not close the record in the state that issued it. You must notify the state if a multiple license has been lost, stolen, or destroyed. You should close your record by notifying the state of issuance that you no longer want to be licensed by that state.

Sections 392.42 and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT BUSINESS DAY of any revocation or suspension of your driver’s license. In addition, Section 383.31 requires that any time you violate a state or local traffic law (other than parking), you must report it to your employing motor carrier and the state that issued your license within 30 days.

DRIVER CERTIFICATION: I certify that I have read and understood the above requirements.

The following license is the only one I will possess.
Driver License No. *
State *
Expiration Date *

/ Month / Day Year
By electronically signing I agree I have read the above statements *
Manual Signature & Date (DO NOT FILL OUT)

Thank you for applying with El Paso - Los Angeles Limousine Express. However, a CDL is required to apply as a Bus Driver. We encourage you to submit your application once you've obtained your CDL license. Thank you for your interest.
Should be Empty:

Street Address
Street Address Line 2
City	State
Zip Code	Country

Street Address
Street Address Line 2
City/State	How Long?
Zip Code	Country

Street Address
Street Address Line 2
City/State	How Long?
Zip Code	Country

Street Address
Street Address Line 2
City/State	How Long?
Zip Code	Country

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

License Information

Professional Commercial Driving School

EMPLOYMENT HISTORY

Accident Record for Past 3 Years

Traffic Convictions / Forfeitures for Past 3 Years (other than Parking Violations)

Driving Experience

Criminal History

Education

Record of Military Service and Reserve Status

Availability

Experience and Qualifications

Driver Notification and Release

School Name
Graduation Date
City	State / Province
Graduation Date	Country

Date
Street Address Line 2
Location / City	Location / State
Postal / Zip Code	Country

Type of Equipment (Articulated, 45', 40', Mini Bus, Flat-Bed, Etc)
Date Range
Date From	Date To
Approx No. of Miles	Country

	Yes	No
Have you EVER been ARRESTED for a crime? (Note: There is no time limit for this question.)
Have you EVER been CONVICTED of a crime? (Note: There is no time limit for this question.)
Have you EVER been ARRESTED or CONVICTED for reckless or careless operation of a motor vehicle?
Have you EVER been ARRESTED or CONVICTED for driving while under the influence of alcohol, a narcotic drug, amphetamines or derivatives thereof?
Have you EVER been ARRESTED or CONVICTED for possession, sale or use of narcotic drug, amphetamines or derivatives thereof?
Have you EVER been ARRESTED or CONVICTED for any serious traffic violation as defined in the FMCSR Part 383.5(c)(2), in the past three (3) years?
Have you EVER been refused any type of insurance or been denied bonding?
Have you EVER been discharged for an accident?
Do you have any warrants out for your arrest?
Have you EVER been denied a license, permit or privilege to operate a motor vehicle?
Has any license, permit or privilege EVER been suspended or revoked?

	Yes	No
Did you ever test positive on any pre-employment drug test in the past three years?
Did you ever test positive on an pre-employment alcohol test in the past three years?
Did you ever refuse a pre-employment drug or alcohol test in the past three years?

Name of High School
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Name of University / College
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

	Yes	No
Load and lift luggage or freight which may weigh approximately 50 lbs
Load and lift luggage or freight which may weigh approximately 100 lbs
Being on duty up to 15 hours
Drive up to 10 hours OTR (Over the Road) or local
Bad weather driving
Night-time / Over-night driving