If you have any questions, please call 1-800-683-0142.

 

Applications will be kept on file for 60 days.

 

Recruiting hours are 8am to 4pm Monday thru Friday.

 

* These fields are required

Personal Information:About You:
* First Name
* Middle Name
* Last Name
* Address
* City * State * Zip
* Phone	( ) -
* Date of Birth	(xx-xx-xxxx)
* SS Number	- - (xxx-xx-xxxx)
In Case of Emergency, Contact:
Name
Phone	( ) -
Relationship
Previous Addresses for the Past Three (3) Years:
Address
City, State, Zip
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Address
City, State, Zip
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Address
City, State, Zip
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Commercial Drivers License Information:
License #
Type	(A,B, or C)
State
Expiration Date
Endorsements	Double/Triple Trailers Tank Vehicles Passenger Vehicles Hazardous Materials
List any additional llicense(s) held in the past three (3) years.
State	Expiration Date (mm-dd-yyyy)
State	Expiration Date (mm-dd-yyyy)
Has your CDL ever been revoked?	Yes        No
If so, explain:
Work Experience:
IN ACCORDANCE WITH PART 391.21 & 23 OF THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS ANAPPLICANT MUST LIST ALL PREVIOUS WORK EXPERIENCE FOR THE THREE YEARS PRIOR TO THE ABOVE APPLICATION DATE, AS WELL AS ALL COMMERCIAL DRIVING EXPERIENCE FOR SEVEN YEARS PRIOR TO THOSE THREE YEARS. PLEASE LIST STARTING WITH MOST RECENT EXPERIENCE.
Company #1
Name
Address
City, State
Supervisor Name
Why Did You Leave?
Job Description
Phone :	( ) -
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Company #2
Name
Address
City, State
Supervisor Name
Why Did You Leave?
Job Description
Phone :	( ) -
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Company #3
Name
Address
City, State
Supervisor Name
Why Did You Leave?
Job Description
Phone :	( ) -
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Company #4
Name
Address
City, State
Supervisor Name
Why Did You Leave?
Job Description
Phone :	( ) -
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Company #5
Name
Address
City, State
Supervisor Name
Why Did You Leave?
Job Description
Phone :	( ) -
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Company #6
Name
Address
City, State
Supervisor Name
Why Did You Leave?
Job Description
Phone :	( ) -
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
Collisions:
PLEASE LIST ALL MOTOR VEHICLE COLLISIONS IN WHICH YOU WERE INVOLVED (BOTH COMMERCIAL AND PRIVATE VEHICLE) DURING THE PAST THREE YEARS PRIOR TO THE APPLICATION DATE. IF NONE, ENTER "NONE" IN DESCRIPTION.
Collision #1
Date	(mm-dd-yyyy)
Description
Location
Injury/Fatalities
Collision #2
Date	(mm-dd-yyyy)
Description
Location
Injury/Fatalities
Collision #3
Date	(mm-dd-yyyy)
Description
Location
Injury/Fatalities
Traffic Convictions and Forfeitures:
PLEASE LIST ALL TRAFFIC CONVICTIONS AND/OR FORFEITURES (BOTH COMMERCIAL AND PRIVATE VEHICLE) FOR THE PAST THREE YEARS (OTHER THAN PARKING). IF NONE, ENTER "NONE" INTO LOCATION.
#1
Date	(mm-dd-yyyy)
Location
Charge
Penalty
#2
Date	(mm-dd-yyyy)
Location
Charge
Penalty
#3
Date	(mm-dd-yyyy)
Location
Charge
Penalty
#4
Date	(mm-dd-yyyy)
Location
Charge
Penalty
#5
Date	(mm-dd-yyyy)
Location
Charge
Penalty
Driving Experience:
Straight Truck
Type of Equipment	(van, tank, flat, etc.)
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
States Driven
Tractor & Semi
Type of Equipment	(van, tank, flat, etc.)
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
States Driven
Tractor & Semi
Type of Equipment	(van, tank, flat, etc.)
From	(mm-dd-yyyy)
To	(mm-dd-yyyy)
States Driven
List of Commodities Hauled
Education
Highest Grade Completed
College
Other Training
Have You Received Any Safety Awards or Special Training?
Do You Have Full Knowledge of the Federal Motor Carrier Safety Regulations?
	Yes        No
Drug & Alcohol Testing History :
IN ACCORDANCE WITH PART 40.25(J) OF THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS, PLEASE ANSWER THE FOLLOWING:
HAVE YOU EVER TESTED POSITIVE, OR REFUSED TO TAKE A DOT DRUG OR ALCOHOL PRE-EMPLOYMENT TEST WITHIN THE PAST THREE YEARS FROM A MOTOR CARRIER WHO DID NOT HIRE YOU?
	Yes        No
IF THE ANSWER TO THE ABOVE QUESTION IS YES, PLEASE LIST THE CONTACT INFORMATION FORTHE SUBSTANCE ABUSE PROFESSIONAL (SAP) WHO COMPLETED YOUR EVALUATION:
Name of SAP
Address
Phone
General :
Have you ever driven for this company before?
	Yes        No
When?	(mm-dd-yyyy)
Where?
IS THERE ANY REASON YOU MIGHT BE UNABLE TO PERFORM THE FUNCTIONS OF THE JOB FORWHICH YOU HAVE APPLIED (AS DESCRIBED IN THE ATTACHED JOB DESCRIPTION)?
	Yes        No
If so, explain if you wish.
HAVE YOU EVER BEEN CONVICTED FOR DUE,DWI,OR OUI?
	Yes        No
Important:
I hereby certify that this application was completed by me, and that all entries on it are tur and complete to the best of my knowledge.   I authorize the carrier to make such inquireies and investigations of my personal, employment, driving, financial or medical history and other related matters as may become 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 agree to abide by the rules and regulations of the carrier as well as the Federal Motor Carrier Safety Regulations. I also agree and understand that if I am selected to drive for the carrier that I will be on a probationary period during which time I may be discharged without recourse.   If all the above information is true and correct, click "AGREE" below.
AGREE?  Yes     No
Where did you hear about us?