Employment Application

 
Have you ever filed an application with us?:
 
 

Personal Information




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Current Address

 






 

Previous Address

*If at the present address for less than three years






Are you currently employed?:
 
Are you subject to recall from lay-off status?:
Have you ever been convicted of a felony?:

(Conviction of a felony may be an obstacle, but will not necessarily disqualify you from employment.)

 
If hired, can you provide proof of eligibility to work in the United States?:
 

Personal transportation to and from work is a required element of this job.

Can you meet this requirement?
 

Consistently staying out of town Monday through Friday is a requirement for this job.

Is there any reason this will be a problem?
 

Some evening work may occasionally be required for this position.

Can you meet this requirement?
 

Some weekend work may occasionally be required for this position.

Can you meet this requirement?
 
Are you willing to relocate?:
 

College

Years of college courses complete
(1-4, Graduate program)
Did you graduate?:
 

Trade/Business/Correspondence School

Did you graduate?:
 

Special studies/skills applicable to construction (list all hands on, mechanical, and electrical experience.)

 

Military

Have you served in the U.S. Military:
 
 
Are you a present member of the National Guard or Reserves?:


 

Because you may be operating company vehicles, you will be required to answer the following questions. In addition, you must submit a copy of your official driving record to be considered for employment.

*The U.S. Department of Transportation requires that driver applicants state their date (mo/day/yr) of birth (§391.21 (b)(2)). The Age Discrimination Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.

Do you currently have a valid driver's license?:
 

Operator's Licenses

(All licenses held in the past three years must be shown.)

License

State

License #

Class

Endorsements

Exp. Date

 

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?:
Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations?:

 

Driving Experience

Class of equipment

(Straight truck, tractor, semi trailer, etc.)

Type of equipment

(Van, tank, flat, etc.)

Dates

(From - to)

Approximate total miles

Accident Review (Past 3 Years)

 

Date

Nature of accident

(Head-on, rear-end, etc.)

Fatalities/Injuries

Last accident

Previous

Next previous
 

Previous Employers

List all employers in the last 10 years, starting with the most recent.

Employer 1

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Employer 2

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Employer 3

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Employer 4

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Employer 5

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Employer 6

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References

May we contact your current supervisor as a reference?

If yes, please include his/her contact information:

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At least two references should be people not related to you for whom you have worked.
One of which must be a military reference if discharged within the past 7 years.

Reference 1

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Reference 2

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Reference 3

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I understand that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, if hired, I will be required to pass a physical examination and a drug/alcohol screen as a condition of employment. I also understand and agree that I may periodically be required to submit to and pass random drug/alcohol screens as a condition of employment. I may also be required to submit to and pass drug/alcohol screens if I exhibit behavior that may, by a reasonable person, be perceived to be indicative of drug and or alcohol abuse.

Nothing on the application is intended to create or imply a contractual relationship; if hired, I understand that employment is at will, i.e., is not for any time period or duration, and can be terminated with or without reason at any time.

Please check the following box to agree to the above:

 

 Security code

 

 

Celebrating 33 Years