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Truck Driver Application For Consideration Of Employment
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Employment Application
Position Desired:     Equipment Experience:  (most used)
  O/O - Make/Model Owned:    Model Year:
Name: First/Middle/Last:   Date of Birth:   Age:
Address:
City:   State:   Zip:
Primary Phone:  Secondary Phone:
Email Address:
Choose Companies to Apply to ( Apply to All )
Arnold Transport
Averitt Express
Bay and Bay
Big M Transport
Celadon
Central Freight
Combined Trans.
CR England
CRST Malone
CRST Van
 Epes Transport
Heartland Express
Interstate Dist. Co.
LandAir
Link America
MCT
Metropolitan
NFI Industries
Perkins Specialized
Roadrunner Trans.
 RWI Transport
SAV Epress
Sharkey Transport
Smith Transport
Smokey Point Dist
Sunco Carriers
Tango Transport
Texas Star Express
Transport America
USA Truck
Willis Shaw Exp.

Background Information
Ever Had a Felony: Yes   No   /  DUI/DWI in last 5 yrs: Yes   No
# Moving Violations: (in last 3 years)   /  # Preventable Accidents: (in last 3 years)
CDL License Information
CDL License Number:   /   CDL Class:   /   State:   /   Expiration:
Social Security: (format: 000-00-0000)
Hazmat Endorsment: Yes   No
# Years Driving OTR:   /   Date Last Drove OTR:   /   CDL Grad Date:
Work History      Yes, I am still with current employer. Do Not Contact until Approved.
1-Current/Most Recent:   Phone:
City:   State:
Equipment Operated:
Employment Dates: From:   To:   (00/0000)
Reason for Leaving:
2-Past Employer:   Phone:
City:   State:
Equipment Operated:
Employment Dates: From:   To:   (00/0000)
Reason for Leaving:
3-Past Employer:   Phone:
City:   State:
Equipment Operated:
Employment Dates: From:   To:   (00/0000)
Reason for Leaving:
4-Past Employer:   Phone:
City:   State:
Equipment Operated:
Employment Dates: From:   To:   (00/0000)
Reason for Leaving:
Please Give More Work History Here and/or Explain Any Negative Background History:
Example:
a) Company #3: USA Trucks: OTR driver from 06/98 to 07/99: I relocated.
b) Ticket: 07/98: GA: illegal lane change: Ticket Paid
c) Felony: 01/89: Domestic Violence: 1 year jail time: I was 22 years old.
Comments/Concerns:
(additional information)
I certify that I personally completed this application for the purpose of employment and that all the information herein is true and correct. I authorize any employer receiving this information to do a complete background investigation in accordance with federal and state laws. In accordance with FMCSR Section(s) 382.405, 382.413, and 391.23, I authorize release of any information, including all information related to my alcohol and controlled substances testing and training records by my former employers and hold them harmless of any liability from release of said information.
Full Legal Signature: