Careers

Name:

List your addresses of residency for the past 3 years.

Current Address

Previous Addresses

Dates:

EMPLOYMENT HISTORY

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. Add another sheet if necessary.)  

EMPLOYER

EMPLOYER

EMPLOYER

*Includes vehicles having a GVWR of 26,001 or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.  

ACCIDENT RECORD FOR PAST 3 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS NEEDED) IF NONE, WRITE NONE

TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS) IF NONE, WRITE NONE

EDUCATION

SELECT HIGHEST GRADE COMPETED:   1    2    3    4    5    6    7    8  

LAST SCHOOL ATTENDED

EXPERIENCE AND QUALIFICATIONS - DRIVER

DRIVERS LICENSES

DRIVING EXPERIENCE IF NONE, WRITE NONE

STRAIGHT TRUCK

TRACTOR AND SEMI-TRAILER

TRACTOR - TWO TRAILERS

MOTORCOACH - SCHOOL BUS

OTHER:

EXPERIENCE AND QUALIFICATIONS - OTHER

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history 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 inquires 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.