Drivers Application For Employment
Company:
Address:
City: State: Zip:
 
(Answer All Questions)
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, matital status, or non-job related disability
 
Position(s) Appilied for:
First Name: Last Name:
Social Security No:
 
List Your Addresses of Residency for the past 3 years
Current Address:
  Street:  City:
  State:  Zip Code: Phone: How Long?
 
Previous Address:
  Street:  City:  State:  Zip Code: How Long?
 
Previous Address:
  Street:  City:  State:  Zip Code: How Long?
 
Previous Address:
  Street:  City:  State:  Zip Code: How Long?
 
Do you have the legal right to work in the United States?
 
Date Of Birth:  Can You Provide Proof of Age?
 
Have you worked for this company before?  
Where?
 
Dates: From  To?  Rate of Pay:  Position:
 
Reason for Leaving: 
 
Are you now employed?   
If not, how long since leaving last employment?
 
Who referred you?   
Rate of pay expected:
 
Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the attached job desctipon)?
If yes, explain if you wish:
 
ACCIDENT RECORD FOR PAST 3 YEARS
Dates Nature of Accident Fatalities Injuries
Last Accident:
Next Previous:
Next Previous:
 
TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS)
Location Date Charge Penalty
 
EDUCATION
Highest Grade Completed?
Highest Grade For High School?
Highest Grade For College?
Last School Attended, Name:  
City:
 
EXPERIENCE AND QUALIFICATIONS - DRIVER
  State License No Type Expiration Date
Driver Licenses
 
A. Have you ever been denied a license or
privilege to operate a motor vehicle?
 
B. Has any license, permit or privilege ever been suspended or revoked?
 
IF THE ANSWER TO EITHER
A OR B IS YES, PLEASE GIVE DETAILS
 
DRIVING EXPERIENCE
Class of Equipment
Type of Equipment
 From Date To Date Approx. No. Of Miles
Straight Truck
Tractor/Semi Trailer
Tractor/Two Trailer
Motorcoach/School Bus
Other
 
List States Operated in For Last Five Years:
 
Show Special Courses Or Training That Will Help You as a Driver:
 
Which Safe Driving Awards Do You Hold and From Whom?
 
Experience And Qualifications - Other
Show Any Trucking, Transportation or Other Experience That May Help In Your Work For This Company:
List Courses And Training Other Than Shown Elsewhere In This Application:
List Special Equipment Or Technical Materials You Can Work With (Other than already shown):
 
Employment History
All driver applicants to drive in interstate commerce must provide the following information on all employees 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.)
 
Employer Date
Name: From:
To:
Address: Position Held:
City: State:
ZipCode: 		Salary / Wage:
Contact: Phone: Reason For Leaving:
 
Employer Date
Name: From:
To:
Address: Position Held:
City: State:
ZipCode: 		Salary / Wage:
Contact: Phone: Reason For Leaving:
 
Employer Date
Name: From:
To:
Address: Position Held:
City: State:
ZipCode: 		Salary / Wage:
Contact: Phone: Reason For Leaving:
 
Employer Date
Name: From:
To:
Address: Position Held:
City: State:
ZipCode: 		Salary / Wage:
Contact: Phone: Reason For Leaving:
 
Employer Date
Name: From:
To:
Address: Position Held:
City: State:
ZipCode: 		Salary / Wage:
Contact: Phone: Reason For Leaving:
 
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