EMPLOYEE APPLICATION FORM

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disabilities.

Date of application *

Position applied for *

Full Name (First Middle Last) *

Current address *

City *

State *

ZipCode *

Home Phone *

Cell Phone *

Drivers Lic. Endorsements *

Current E-mail Address *

Do you have the legal right to work in the United States? *

Have you ever been convicted of an offense that would prevent you from entering Canada? ie: DUI, Narcotics, Domestic, etc *

Who referred you to our company? *

Date of birth (Required only for CDL applicants)

Do you have a current Medical Card? *

If (YES), Medical Card Expiration Date

Have you been drug/alcohol tested in the last 6 months? *

Do you have tractor/trailer driving experience? *

If (YES), How many years driving experience?

Do you have experience pulling a TANKER? *

Do you have experience pulling a VANS? *

Are you knowledgeable in log book regulations? *

EMPLOYMENT HISTORY

All driver applicants to drive interstate commerce must provide the following information on all employers during the previous 3 years. List complete mailing address, street number, city, State, and zip code.

Applicants to drive a commercial motor vehicle*in interstate commerce shall also provide an additional seven years information on those employers for whom the applicant operated a interstate vehicle.
(NOTE: If additional space is needed, submit a 2nd application with only Employment History section completed.)

List employers in reverse order starting with the most recent.

EMPLOYER

ADDRESS

CITY

STATE

ZIP

EMPLOYED: FROM (Month / Year)

EMPLOYED: TO (Month / Year)

EMPLOYER

ADDRESS

CITY

STATE

ZIP

EMPLOYED: FROM (Month / Year)

EMPLOYED: TO (Month / Year)

EMPLOYER

ADDRESS

CITY

STATE

ZIP

EMPLOYED: FROM (Month / Year)

EMPLOYED: TO (Month / Year)

EMPLOYER

ADDRESS

CITY

STATE

ZIP

EMPLOYED: FROM (Month / Year)

EMPLOYED: TO (Month / Year)

Addition Information you would like to add in your consideration for Employment: