Driver Application Form

  • Information

  • Education

  • DOT Requirements

  • MM slash DD slash YYYY
  • Driving Experience

    Answer this group of questions regarding the last 3 years.

  • History of Employment

    Federal Motor Carrier Safety Regulations require driver applicants to provide a ten (10) year prior employment history.

  • Employer Start Date End Date Actions

  • Driver Certification and Application Information Agreement

    I certify that this application was completed by me, and that the answers given herein are true and complete to the best of my knowledge. I also authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that information I provide regarding current and/or previous employers may be used, and those employers(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23 and (e). I understand that I have the right to: - Review information provided by current/previous employers and for those 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.

  • 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 the Employer.