Driver Application Form

This is a most IMPORTANT part of application. It must be answered ACCURATELY and IN DETAIL. List any and all tickets or arrests for any Motor Vehicle Law violations with any type vehicle in past five (5) years (other than parking tickets).

Begin with your present employer and work backward, in order, listing all of your previous employers, driving school and other training programs, periods of military service, self-employment and periods of unemployment. List this information going back at least for the past 10 years. All time must be accounted for. Fill in ALL blanks. If discharged from any job, please explain.

The information that you provide may be used, and your previous and current employer(s) will be contacted, for the purpose of investigating your safety performance history while employed, as required by the Federal Motor Carrier Safety Regulations (FMCSRs) Part 391.23. In accordance with these regulations and with regard to information provided by DOT - regulated employers, you have the following rights regarding any information provided to the Company as a result of these inquiries: (1) The right to review information provided by previous employers; (2) The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the Company, and (3) The right to have a rebutall statement attached to the alleged erroneous information if you and your previous employer(s) cannot agree with the accuracy of the information your previous employer submits. For a full understanding of your rights as an applicant under FMCSR Part 391 you should refer directly to FMCSRs.

Leave NO BLANKS or gaps in time for the past 10 years period.