In compliance with Federal and State equal opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected status.*
List your addresses of residency for the past 3 years *
All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operated such vehicle. (NOTE: List employers in reverse order starting with the most recent. Press (+) if Applicable)
vehicle operating history
Please list current driver's licenses or permits held: *
Please note that a "Yes" answer to any of the following questions will not necessarily disqualify you from employment.
Please fill in the information below about your driving experience.
TO BE READ AND SIGNED BY APPLICANT - I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release 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 employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. - I understand that information that I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49CFR 391.23(d) and (e). I understand that I have the right to: 1) Review information provided by previous employers; 2) Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and 3) Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. *
Electric Signature - Please type your First and Last Name. *