Apply Online

    10%

    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. I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history, and other related matters as may be necessary for 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 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 the Company.

    Driver's Application for Employment

    In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job-related disability.

    20%

    Applicant to Complete

    List your addresses of residency for the past 3 years

    Current Address

    Previous Address (Fill Previous Address only if current address is less than 3 years)


    Dates:

    30%

    Employment History

    All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding three (3) years. List the complete mailing address, including street number, city, state, and ZIP code. Applicants to drive a commercial motor vehicle in intrastate or interstate commerce must also provide an additional seven (7) years of information on those employers for whom the applicant operated such vehicles.

    Note: List employers in reverse order starting with the most recent. Add another sheet if necessary.

    Employer 1

    Employment Dates*

    Employer 2

    Employment Dates

    Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any vehicle used to transport hazardous materials in quantities 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 more than 8 passengers (including the driver), or (3) is used to transport hazardous materials requiring placarding.

    40%

    Declaration of Employment Status

    Under Federal Motor Carrier Safety Regulations (391.23), Casual Driver Leasing Services is required to verify the preceding three years of employment background for all prospective commercial drivers. If you were unemployed or self-employed for more than thirty (30) consecutive days within the past three (3) years, complete this part and provide the required documentation.

    Dates


    During the date(s) specified above, the following statement(s) are true & correct. Check ALL that apply.


    50%

    Accident Records


    FOR THE PAST THREE YEARS OR MORE. IF NONE, CHECK THE BOX AT THE END OF THIS SECTION

    LAST ACCIDENT

    NEXT PREVIOUS ACCIDENT

    NEXT PREVIOUS ACCIDENT

    NEXT PREVIOUS ACCIDENT

    60%

    Traffic Convictions


    AND FORFEITURES FOR THE PAST THREE YEARS (OTHER THAN PARKING VIOLATIONS). IF NONE, CHECK THE BOX AT THE END OF THIS SECTION

    TRAFFIC CONVICTIONS RECORD 1

    TRAFFIC CONVICTIONS RECORD 2

    TRAFFIC CONVICTIONS RECORD 3

    70%

    Qualification - Driver

    DRIVER LICENSES OR PERMITS IN THE PAST 3 YEARS









    80%

    Driving Experience



    Dates




    Dates




    Dates




    Dates





    100%

    Experience & Qualifications - Others




    Education




    TO BE READ AND SIGNED BY THE 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.


    I authorize you to make such investigations and inquiries of my personal, employment, financial 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 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 the Company.



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