If at the above residence less than three years, list below all residences for the past three years. Attach a separate sheet if necessary.
Describe any military training received relevant to the position for which you are applying.
Conviction of a crime is not an automatic bar to employment - all circumstances will be considered.
Driver Experience and Qualifications
The Federal Motor Carrier Safety Regulations 49CFR391.21 (b) (2) required that driver applicants state their date of birth and SS#.
The Federal Motor Carrier Safety Regulations 49CFR391 Subpart E required that all driver applicants pass certain physical tests before they are hired to drive a motor vehicle.
Alcohol and Controlled Substance Statement
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's License Information
Driver's Licenses held in past 3 years must be shown
Accident Review for the past 3 years (attach a separate file if more space is needed)
Motor Vehicle Driving Record
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 3 years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional 7 years for a total of 10 years. Any gaps in employment must be explained.
Start with the last or current position, including any military experience, and work back. Attach a separate file if necessary. You are required to list the complete mailing address.
Applicant Must Read
I verify that I have read and understand all of this employment application. It is agreed and understood that this 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 herein 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 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.