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 Employement

    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)

    30%

    Employment History

    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 addi-tional 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.)

    Employer

    Date *

    Employer 2

    Date

    Employer 3

    Date

    Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding. 1The 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 of any size and is used to transport hazardous materials in a quantity 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 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) is/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 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.