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Driver Application

Driver Application

Application for Employment - Commercial Driver

Current Address

Dates:

EDUCATION

Last school attended

MILITARY EXPERIENCE

GENERAL

The Federal Motor Carrier Safety Regulations (49CFR391.21 (b)(2)requires that driver applicants state their date of birth and SS#.

The Federal Motor Carrier Safety Regulations (49CFR391 SubpartE) requires that all driver applicants pass certain physical tests before they are hired to drive a motor vehicle.

The Federal Motor Carrier Safety Regulations 49CFR40.25(j) requires all persons with applying for a driving position requiring a commercial drivers license to answer the following questions:

Driver Licenses held in past 3 years must be shown:

DRIVING EXPERIENCE

Class of Equipment

Type of Equipment 

(Van, Tank, Flat, etc.)

From                                           To

Approximate Total Miles

Straight Truck

Tractor and Semi-Trailer

Other

DRIVER EXPERIENCE AND QUALIFICATION (continued)

Accident Review for the past 3 years (attach a separate sheet of paper if more space is needed). 







Traffic Convictions and Forfeitures for the past 3 years other than parking violations.

The Federal Motor Carrier Safety Regulations (49CFR391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years for a total often (10) years. Any gaps in employment must be explained.


Start with the last or current position, including any military experience, and work back (Attach separate sheet if necessary.) You are required to list the complete mailing address: street number, city, state and zip code.






I certify that I have read and understand all of this employment application. It is agreed and understood that the employer or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant releases employers and other persons named here in from all liability for any damages on account of his furnishing such information. I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks that are pertinent to the job.


It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigative Consumer Report, including information regarding my character, personal reputation, personal characteristics and mode of living.


I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.


I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal.


If hired, I agree to abide by all the rules and policies of the employer.


This certifies 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

Standard Application For Employment

     It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classification.
      Please carefully read and answer all questions. You will not be considered for employment If you fail to Completely answer all the questions on this application. You may attach as résumé, but all questions must be answered.

Werdco BC, Inc.

PERSONAL DATA

POSITION INFORMATION  check all that you are willing to work

Hours

Status

QUALIFICATIONS  Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational and  technical programs and military training.

School Name

Degree

Address/City/State

SPECIAL SKILLS  List any special skills or experinece that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.)

REFERENCES  Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don't have three professional references, then list personal, unrelated references.

WORK HISTORY  Start with your present or most resent employment and work back. Use separate sheet if necessary (INCLUDE PAID AND UNPAID POSITIONS)

      I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that If I am employed, false statements, omissions or misenterpresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this Application.

      I acknowledge and understand that the company is an "at will" employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.

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