Position(s) Applied for
ADDRESS FOR PAST THREE YEARS
Reason for leaving?
If not, how long since leaving last employment?
How did you hear about us?
Rate of pay expected
All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state, and zip code. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operated such vehicle. (NOTE: List employers in reverse order starting with the most recent. Add another sheet as necessary.) Your present and previous employers will be contacted for the purpose of investigating your safety performance history as required by FMCSA. Please use additional paper if necessary.
Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.
The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport 9 or more passengers, OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.
If yes, please explain fully on a separate sheet of paper and upload that here. Conviction of a crime is not an automatic bar to employment-all circumstances will be considered.
Experience and Qualifications- Driver
List all driver licenses or permits held in the past 3 years
List States operated in the last five years :
Show Special Courses or Training that will help you as a Driver:
Which Safe Driving Awards do you hold and from whom?
ACCIDENT RECORD FOR THE PAST 3 YEARS OR MORE
TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS
Driver's License Upload
Please upload a copy of your driver's license here:
EXPERIENCE AND QUALIFICATIONS
Show any Trucking, Transportation or other Experience that may help in your work for this company:
List Courses and Training other than shown elsewhere in this application:
List special equipment or technical materials you can work with (other than those already shown):
Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the attached job description)?
If yes, explain if you wish:
TO BE READ AND SIGNED BY APPLICANT This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
As part of the application process, I am aware that certain prequalification procedures are involved. This may include a driving test, training and other pre hiring examinations. I understand and agree that during this period I am not an employee of the company, and I am not entitled to receive any pay or compensation for my time spent in these procedures.
I authorize you to make such investigations and inquiries of my personal, employment, financial and/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. In the event of 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 Fastrak Express, Inc
I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and
(e). I understand that I have the right to:
Review information provided by previous employers;
Have errors in the information corrected by previous employers and for those previous employers to re-send the Corrected information to the prospective employer; and
Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.