DATES EMPLOYED: FROM               TO              COMPANY:                              TITLE:

STREET:                      CITY:                        STATE:                         ZIP:

PHONE NUMBER:                            CONTACT PERSON:

WAS THIS A DRIVING POSITION:                      WHAT TYPE OF TRUCKS:

REASON FOR LEAVING:
DATES EMPLOYED: FROM               TO              COMPANY:                              TITLE:

STREET:                      CITY:                        STATE:                         ZIP:

PHONE NUMBER:                            CONTACT PERSON:

WAS THIS A DRIVING POSITION:                      WHAT TYPE OF TRUCKS:

REASON FOR LEAVING:
DATES EMPLOYED: FROM               TO              COMPANY:                              TITLE:

STREET:                      CITY:                        STATE:                         ZIP:

PHONE NUMBER:                            CONTACT PERSON:

WAS THIS A DRIVING POSITION:                      WHAT TYPE OF TRUCKS:

REASON FOR LEAVING:
DATES EMPLOYED: FROM               TO              COMPANY:                              TITLE:

STREET:                      CITY:                        STATE:                         ZIP:

PHONE NUMBER:                            CONTACT PERSON:

WAS THIS A DRIVING POSITION:                      WHAT TYPE OF TRUCKS:

REASON FOR LEAVING:
DATES EMPLOYED: FROM               TO              COMPANY:                              TITLE:

STREET:                      CITY:                        STATE:                         ZIP:

PHONE NUMBER:                            CONTACT PERSON:

WAS THIS A DRIVING POSITION:                      WHAT TYPE OF TRUCKS:

REASON FOR LEAVING:
DATES EMPLOYED: FROM               TO              COMPANY:                              TITLE:

STREET:                      CITY:                        STATE:                         ZIP:

PHONE NUMBER:                            CONTACT PERSON:

WAS THIS A DRIVING POSITION:                      WHAT TYPE OF TRUCKS:

REASON FOR LEAVING:
DATES EMPLOYED: FROM               TO              COMPANY:                              TITLE:

STREET:                      CITY:                        STATE:                         ZIP:

PHONE NUMBER:                            CONTACT PERSON:

WAS THIS A DRIVING POSITION:                      WHAT TYPE OF TRUCKS:

ARE YOU CURRENTLY WORKING FOR THIS EMPLOYER:

REASON FOR LEAVING:
HAVE YOU EVER BEEN ARRESTED FOR DWI/DUI:     YES          NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:


HAVE YOU EVER BEEN CHARGED OR CONVICTED OF A FELONY:     YES         NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:


HAVE YOU EVER BEEN CHARGED OR CONVICTED OF A MISDEMEANOR:     YES         NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:


HAVE YOU EVER TESTED POSITIVE OR REFUSED A DRUG OR ALCOHOL TEST:     YES          NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:


HAS YOUR LICENSE EVER BEEN SUSPENDED OR REVOKED:     YES          NO
IF SO, PLEASE LIST DATES, CITY, STATE, AND DESCRIPTION:


HAVE YOU HAD ANY TRAFFIC TICKETS IN THE LAST 5 YEARS:     YES         NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:


HAVE YOU HAD ANY TRAFFIC ACCIDENTS IN THE LAST 5 YEARS:     YES         NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:


HAVE YOU EVER EVER BEEN IN TRAFFIC ACCIDENT THAT RESULTED IN A FATALITY:     YES         NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:


HAVE YOU EVER HAD A “ROLL OVER” OR “LOW BRIDGE” ACCIDENT:     YES         NO
IF SO, PLEASE LIST THE DATES, CITY, STATE, AND DESCRIPTION:
HAVE YOU EVER BEEN IN THE MILITARY:    YES          NO

WERE YOU HONORABLY DISCHARGED:     YES          NO
ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE U.S?     YES         NO

HAVE YOU EVER BEEN TO A TRUCK DRIVING SCHOOL?     YES         NO

IF YES, SCHOOL NAME, DATE, LOCATION:

WHAT IS YOUR DRIVING PREFERENCE?  SOLO     TEAM     HUSBAND & WIFE TEAM

HOW MANY MONTHS OF VERIFIABLE TRACTOR TRAILER EXPERIENCE DO YOU HAVE?

HOW LONG HAS IT BEEN SINCE YOU HAVE OPERATED A TRACTOR TRAILER?

HOW MANY STATES HAVE YOU DRIVEN A TRACTOR TRAILER IN?

DO YOU HAVE 6 MONTHS WORK EXPERIENCE OF ANY KIND IN THE LAST 3 YEARS?     YES          NO
THANK YOU FOR YOUR APPLICATION. IF YOU MEET THE MINIMUM HIRING GUIDELINES,
WE WILL BE CALLING YOU IN THE NEAR FUTURE.

SINCERELY,

ROAD 2 SUCCESS TRUCKING
Application For Employment
COMPANY APPLYING FOR:
TYPE OF POSITION YOU ARE APPLYING FOR:
FULL NAME (FIRST, M.I.,LAST) :
STREET ADDRESS:
CITY / STATE :
EMAIL ADDRESS:
HOME PHONE:
CELL PHONE:
BIRTH DATE:
PLACE OF BIRTH (STATE,CITY,COUNTRY):
DRIVERS LICENSE NUMBER:
DRIVERS LICENSE STATE:
DRIVERS LICENSE EXPIRATION DATE:
HAVE YOU HAD A LICENSE IN ANY OTHER STATE? IF SO, PLEASE LIST THE STATE AND THE LICENSE NUMBER:
ZIP:
WHEN WOULD YOU LIKE TO START?
IMMEDIATELY:
2 WEEKS:
3 WEEKS:
DRIVERS LICENSE ENDORSEMENTS:
HAZMAT:
TANKER:
DO YOU HAVE A CLASS A CDL?
HAVE YOU HAD A VALID US LICENSE FOR THE PAST 2 YEARS?
YES
YES
NO
NO
SOCIAL SECURITY NUMBER:
DOUBLE/TRIPLE:
PERSONAL REFERENCES: (FILL OUT ALL THREE)
REFERENCES WILL NEED TO BE FRIENDS OR CO-WORKERS.
PLEASE LIST: FIRST AND LAST NAMES, WERE THEY LIVE, AND THERE PHONE NUMBER.
3.
1.
2.
BACKGROUND INFORMATION
PLEASE BE AS THOROUGH AS POSSIBLE
WORK EXPERIENCE
1.
2.
EXPERIENCED DRIVERS: 10 YEARS WORK HISTORY
NON-EXPERIENCED DRIVERS: 3 YEARS WORK HISTORY
3.
4.
5.
6.
7.
PLEASE LIST ANY PERIODS OF UNEMPLOYMENT:
UNEMPLOYMENT
DRIVER APPLICATION DISCLAIMER

BY SUBMITTING THIS APPLICATION I CERTIFY THAT I PERSONALLY HAVE COMPLETED THIS APPLICATION
AND THAT ALL OF THE INFORMATION IS TRUE AND CORRECT.
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