Transportation Driver Employment Application

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Please TYPE or PRINT clearly. To be considered for employment, this Employment Application must be completed and signed personally by the applicant. Each question must be answered in full, even if a resume is provided. If an answer is NO or NOT APPLICABLE, indicate such.
We are an Equal Opportunity Employer. We consider all applications for all positions without regard to race, religion, creed, color, sex, age, national origin, disability, sexual orientation, marital or familial status, pregnancy, military status, veteran status, predisposing genetic characteristics or carrier status, arrest or conviction record, domestic violence victim status, or any other protected class or status. Applicants requiring a reasonable accommodation to participate in the application and/or interviewing process should notify an organization representative.

BIOGRAPHICAL DATA

Name (First, Middle, Last)

Telephone Number

E-mail Address*

Cell Phone Number

Street Address

City

State

Zip Code

Position Applied For

Salary or Hourly Wage Desired

Are you Available to Work (check all that apply)

Full-Time

Part-Time

Temporary

Day

Evening

Nights

Date Available to Begin Work

Are you 18 years of age or older?

Yes

Are you currently employed?

Yes

if yes, may we contact your employer to obtain employment information?

Yes

Have you ever submitted an application and/or interviewed for employment with our organization?

Yes

If yes, give month and year

Have you ever been employed with our organization before?

Yes

If yes, give dates.

From

Are you legally eligible for employment in the United States?

Yes

Employment eligibility will be verified upon employment.

If you have had an opportunity to review a job description for the position for which you are applying, can you perform the essential functions of this job with or without reasonable accommodation? (check N/A if you have not reviewed a job description)

Yes

N/A

EDUCATIONAL BACKGROUND

High School

Name and Location of School

# of Years Completed

Did you Graduate?

Yes

Diploma or Degree Obtained

GPA

College

Name and Location of School

# of Years Completed

Did you Graduate?

Yes

Diploma or Degree Obtained

GPA

Dates Attended From

Dates Attended To

Other

Name and Location of School

# of Years Completed

Did you Graduate?

yes

Diploma or Degree Obtained

GPA

SKILLS

List any additional skills, training, and/or technical/professional knowledge that is relevant to the job for which you are applying:

List any certificates, licenses, or professional achievements that would support your qualifications for employment:

Drivers’ License Identification Number:

State of Issuance:

(Provide your driver's license ID number ONLY if it is a requirement of the position for which you are applying)

EMPLOYMENT HISTORY

Provide employment information, including military service, for the last 15 years, starting with the most recent employer first. If you've held more than four jobs, provide this information on another sheet and attach to this Application Form.

Present or Last Employer

If current employer, may we contact?

Yes

No

Name of Employer

Phone Number

Employment Dates (Month/Year)

Current or Ending Pay Rate

Address

City / State / Zip

Title of Position

Name and Title of Supervisor

Description of duties, responsibilities and significant accomplishments

Reason for leaving

Next Previous Employer

Name of Employer

Phone Number

Address

City / State / Zip

Employment Dates (Month/Year)

Ending Pay Rate

Title of Position

Name and Title of Supervisor

Description of duties, responsibilities and significant accomplishments

Reason for leaving

Next Previous Employer

Name of Employer

Phone Number

Address

City / State / Zip

Employment Dates (Month/Year)

Ending Pay Rate

Title of Position

Name and Title of Supervisor

Description of duties, responsibilities and significant accomplishments

Reason for leaving

Next Previous Employer

Name of Employer

Phone Number

Address

City / State / Zip

Employment Dates (Month/Year)

Ending Pay Rate

Title of Position

Name and Title of Supervisor

Description of duties, responsibilities and significant accomplishments

Reason for leaving

REFERENCES (List three references other than relatives)

Name/Occupation

Phone Number

Address

City

State

Zip

Years Known

Name/Occupation

Phone Number

Address

City

State

Zip

Years Known

Name/Occupation

Phone Number

Address

City

State

Zip

Years Known

CONVICTION RECORD STATUS

All applicants and employees must, as a condition of employment, inform the organization of all convictions. This includes all convictions received within the past seven years, while your application for employment is pending, and within seven days of receiving a conviction if currently employed.

Have you been convicted of, and/or plead guilty to, a felony or misdemeanor in the past seven years?

Yes

No

If you answered ‘yes’ and have been convicted of a felony or misdemeanor, please provide additional information below, such as the crime(s), date(s), court location, sentencing information, disposition of sentence, and rehabilitation completed. Please note that a ‘yes’ answer to this question does not necessarily disqualify an applicant for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime as it relates to the job applied for, and rehabilitation will be considered. The organization reserves the right to reject individuals for employment based on job-related convictions.

Date of Offense
MM slash DD slash YYYY

County and State in which Offense Occurred

Conviction/Explanation

Rehabilitation Completed

Date of Offense
MM slash DD slash YYYY

County and State in which Offense Occurred

Conviction/Explanation

Rehabilitation Completed

PLEASE READ CAREFULLY AND SIGN BELOW (LAST STEP AFTER ENTIRE FORM IS COMPLETED)

I hereby certify that all of the information I have provided on this Employment Application is true and correct to the best of my knowledge. I understand that any misrepresentation or omission of facts will disqualify me from further consideration of employment, withdrawal of any offer of employment, or, termination of employment, if already hired.
I authorize verification of all of the information I have provided on this Employment Application and understand that additional information may be needed to consider my application for employment. I authorize all previous employers, educational institutions, references, and other persons who have knowledge of me or my records to provide any and all information pertinent to my employment and release the same from any liability resulting from providing such information. I also release this organization and all of its employees from all liability for any damage that may result from reliance on the information furnished.
I authorize permission to secure an Abstract of Driving Record (MVR) from the State issuing my CDL, or shall furnish it upon request.
The organization is committed to providing a drug and alcohol-free workplace. After receiving a conditional offer of employment, I understand that a drug test will be required before starting work. If the results of the test are positive, I understand that the offer of employment will be withdrawn.
I understand that if employed, I am required to abide by all policies, procedures, rules, and regulations of the organization. I also understand and agree that, if hired, my employment is “at-will” and is for no definite period and may, regardless of the date of payment of my wages or salary, be terminated by myself or the organization at any time with or without cause or notice.

Date
MM slash DD slash YYYY

Signature of Applicant
Max. file size: 2 GB.

APPLICANTS FOR POSITIONS TO DRIVE A COMMERCIAL MOTOR VEHICLE ONLY

All applicants for positions requiring the operation of a Commercial Motor Vehicle must complete the following information. A ‘Commercial Motor Vehicle’ includes vehicles with a gross vehicle weight rating (GVWR) of more than 26,000 pounds; drivers of vehicles designed to transport sixteen (16) or more passengers, including the driver; and drivers of vehicles used to transport hazardous materials, regardless of whether the vehicles operate interstate or intrastate.

DRIVER LICENSES

STATE

LICENSE NUMBER

TYPE

EXPIRATION DATE
MM slash DD slash YYYY

STATE

LICENSE NUMBER

TYPE

EXPIRATION DATE
MM slash DD slash YYYY

STATE

LICENSE NUMBER

TYPE

EXPIRATION DATE
MM slash DD slash YYYY

1)Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Yes

No

2)Has any license, permit or privilege ever been suspended or revoked?

Yes

No

If the answer to questions (1) or (2) is ‘yes’, please provide details:

List states operated in for last five years: