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    Employment Application
  • Your Personal Information
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  • Emergency Contact Information
  • 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 the presence of a non job related medical condition or handicap.
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  • Driver / Salesman questions
     
  • Driving Experience

  • Accident Record for the Past 3 Years
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  • Traffic Convictions & Forfeitures for the Past 3 Years
  • (not including parking violations)
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  • Previous 3 Years Residency
  • Address #1:
  • Address #2:
  • Address #3:
  • Driver / Salesman questions (cont.)
  • Equipment Experience

  • Employment Record
  • Applicants that desire to drive in intrastate/interstate commerce must provide the following information on all employers during the previous three (3) years. You must give the same information for all employers you have driven a commercial motor vehicle for the seven (7) years prior to the initial three years (total of ten years employment record). ALL APPLICANTS ARE REQUIRED TO FILL THIS PORTION OF APPLICATION OUT.
  • LAST EMPLOYER
  • 2nd TO LAST EMPLOYER
  • 3rd TO LAST EMPLOYER
  • 4th TO LAST EMPLOYER
  • License Information
  • Section 383.21 FMCSR states "No person who operates a commercial motor vehicle shall at any time have more than one driver"s license. I certify that I do not have more than one motor vehicle license, the information for which is listed below.
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  • Education &/or Formal Training
  • TO BE READ AND ACKNOWLEDGED BY APPLICANT
  • I authorize you to make sure investigations and inquiries to my personal, employment, financial, or medical history and 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 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 understand, also, that I am required to abide by all rules and regulations of the Company. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to: - Review information provided by current/previous employers; - Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and - Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
  • By selecting "Yes", I certify that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.
  • Note: a motor carrier may require an applicant to provide information in addition to the information required by the Federal Motor Carrier Safety Regulations.
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  • Should be Empty: