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Drivers Application for Employment

All portions of this application must be completed. All recruitment and selection activities will be conducted without regard to race, creed, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, marital status, status with regard to public assistance, membership or activity in a local commission, any other protected class status defined by applicable local, state, or federal laws. 

Application Information
Previous Three Years Residency
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License Information

No person who operates a commercial motor vehicle shall at any time have more than one driver’s license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years; attach additional sheets if needed. 

Current License Information
Previously Held License Information
Driving Experience

Check all that apply.

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Accident Record for the Past 3 Years

List most recent accident first.

Chemical Spills?
Chemical Spills?
Chemical Spills?
Traffic Convictions and Forfeitures for the past 3 years
(Other than parking violations) 

List most recent violation first.

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
Has any license, permit, or privilege ever been suspended or revoked?
Do you have a FMCSA Driver Clearinghouse account? Please check one.
Employment History

The Federal Motor Carrier Safety Regulations (49 CFR 391.21) 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 of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.

 

Start with the last or current position, including any military experience, and work backwards (attach separate sheets if necessary). You are required to list the complete mailing address, including street number, city, state, zip; and complete all other information. 

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?
Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?
Education
Did you Graduate?