Commercial Driver Application

Fill in ALL blanks & provide ALL information requested.

An Equal Opportunity Employer
WE DO NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, SEX, AGE, DISABILITY, OR ANY OTHER STATUS PROTECTED BY LAW OR REGULATION. IT IS OUR INTENTION THAT ALL QUALIFIED APPLICANTS BE GIVEN EQUAL OPPORTUNITY AND THAT SELECTION DECISIONS BE BASED ON JOB-RELATED FACTORS.

Commercial Driver Application

Personal Information

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Email
Primary Phone
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If your above address is less than 3 years, continue listing below to cover the previous 3 year period.
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Driver's License Information

Please provide all licenses held for the past 3 years.

Experience

Accident History

Please provide accident history for the past 3 years. If none, please skip.

Traffic Violations

Please list all traffic violations for the past 3 years. If none, please skip.

Have you ever had any driver license denied, suspended, revoked or cancelled by any issuing state agency?

Employment History

Please provide 10 years of employment history and account for gaps between employers. If owner/operator, list carriers leased to.
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For driver applicants of commercial motor vehicles that require a Commercial Driver License (CDL) the applicant must disclose their controlled substance and alcohol status per the requirements of 49 CFR part 40.25(j).

As a prospective driver employee, you have the right to review information provided by previous employers. You have the right to have errors in the information corrected by the previous employer(s) to re-send the corrected information to the prospective employer; the right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

Driver employees who have previous Department of Transportation regulated employment history in the preceding three years, and wish to review previous employer provided investigative information, must submit a written request to the prospective employer, which may be done at anytime, including when applying or as late as thirty (30) days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), then the five (5) business day deadlines will begin when the prospective employer receives the requested safety performance history information. If the driver has not arranged to pick up or receive the requested records within thirty (30) days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived their request to review the records.

Sending