DRIVER'S APPLICATION FOR EMPLOYMENT
It is our policy to provide equal employment opportunity to qualified persons without discrimination because of any characteristics protected by applicable, local, state or federal law.
Where did you hear about our job posting? Facebook, Twitter, and/or LinkedIn
Indeed.com
the Washington Post
Craigslist.com
Current employee
Other, please specify:
Name:      (First, Middle, Last)
Email:
Home Phone:
Address:
City:
County:
State:
Zip:
How long at this address?
REFERRED BY:
Position Applied For: NON-CDL Truck CDL Driver
Class: A B C
Expiration Date on Medial Examiner's Certificate / / (mm/dd/yyyy)
Driver's License Information
State/License No. Type (A, B, C, etc) Endorsements Expiration Date
Address On Driver's License:
Address For The Past Three Years" 1.
Street:

City:

State & Zip code:

How long?


2.
Street:

City:

State & Zip code:

How long?


3.
Street:

City:

State & Zip code:

How long?


Are you legally eligible for employment in the United States? Yes No
EMPLOYMENT HISTORY
All driver applicants must provide the following information on all previous employers for the past three years. Those applying for a position to drive a commercial motor vehicle requiring a CDL* must provide an additional 7 years of employment history (total of 10 years). List most recent past employer first and so on. Attach additional sheet if necessary.
1.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
2.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
3.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
4.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
5.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
6.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
7.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
8.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
9.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
10.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
11.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
12.
Company Name:


Address:


City:     State:     Zip: 

Position Held:


From: To:

Reason for Leaving:


Person To Contact:


Phone:
( )
Background Information
Please provide the following information for the past three years:
Accident Record
Dates Nature Of Accident
(Head-On, Rear-End, Upset, Etc.)
Fatalities Injuries Were you cited?
Charged?
Type of vehicle operated
Traffic Convictions And Forfeitures
(Other than parking violations)
Location State Date Charge Penalty Points

NOTE: We will obtain a copy of your motor vehicle record maintained by each state in which you have been licensed in the past three years as required of us by Federal regulation.
Education: Choose Highest Grade Completed:
1
2
3
4
5
6
7
8

High School:
1
2
3
4

College:
1
2
3
4

Last School Attended:

City:

Experience And Qualifications
Class Of Equipment Type Of Equipment
(Van, Tank, Flat, Etc. )
Dates Approx No. Of Miles
    From to  
Straight Truck (single unit)
Tractor And Semi-Trailer
Tractor-Two Trailers
Others
A.
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Y N

B.
Has any license, permit or privilege ever been suspended or revoked?
Y N

C.
Have you been convicted of a felony in the past 7 years?
Y N
If so, year convicted?

D.
Have you tested positive, or refused to test, on any pre-employment drug screen within the previous 2 years
Y N
Experience And Qualifications - Other Tell us about any trucking, transportation or other experience that would benefit you in working for us:


List educational courses and training not shown elsewhere on this application:


List special equipment operated or technical skills not shown elsewhere on this application:


Have you worked for us before?


When/Where?


Dates:
From:

To:


Rate of Pay:


Position:


Reaons for Leaving:


LIE DETECTOR NOTICE
Under Maryland law, an employer may not require or demand, as a condition of employment, prospective employment, or continued employment, that an individual submit to or take a lie detector or similar test. An employer who violates this law is guilty of a misdemeanor and subject to a fine not exceeding $100.
TO BE READ AND SIGNED BY APPLICANT
This certifies that I completed this application personally, and that all entries on it and information in it are true and complete to the best of my knowledge. In the event of my 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, as permitted by Law. My services and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the Company or myself. I understand that no individual or representative of the Company other than the President has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement to the contrary. I authorize you to make such investigations and inquiries of 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.

Date:


Applicant Full Name: