Drivers Application





Untitled Document

DRIVER'S
APPLICATION FOR EMPLOYMENT
 
Ace Transport LLC.
PO Box 189
919-284-2074
 
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.
 
Date of Application:
 
Name: SSN:
Address: Phone Number:
Cell Number:
 
Date of Birth: Email:
 
Have you ever been convicted of a crime?
If Yes, please explain:
 
List your residency for the past 3 years:
Previous Address:
How long:
Previous Address:
How long:
Previous Address:
How long:
 
Have you worked for this company before?
Dates: From: To:
Reason for Leaving:
Who Referred You:
Are you now employed? If not, how long since leaving last employment?
 
Is there any reason you might be unable to perform the functions of the job for which you have applied?
If yes, explain:
 
Employment History
All driver applicants must provide complete mailing address, street number, city, state, zip code and contact numbers for companies worked for in the past 10 years.
 
Employer: Position Held:
Address: From To:
City: State Zip:
Phone Number: Contact:
Reason for Leaving: Pay Rate:
Employer: Position Held:
Address: From To:
City: State Zip:
Phone Number: Contact:
Reason for Leaving: Pay Rate:
Employer: Position Held:
Address: From To:
City: State Zip:
Phone Number: Contact:
Reason for Leaving: Pay Rate:
Employer: Position Held:
Address: From To:
City: State Zip:
Phone Number: Contact:
Reason for Leaving: Pay Rate:
Employer: Position Held:
Address: From To:
City: State Zip:
Phone Number: Contact:
Reason for Leaving: Pay Rate:
Employer: Position Held:
Address: From To:
City: State Zip:
Phone Number: Contact:
Reason for Leaving: Pay Rate:
Accident Record for Past 3 Years: If None, write None:
Dates
Nature of Accident
Fatalities
Injuries
 
Traffic Convictions and Forfeitures for the past 3 years (other than parking violations): If none, write None:
Dates
Nature of Accident
Fatalities
Injuries
 
Driver's License(s) Information
State
Driver's License #
Type
Expiration Date
 
Driving Experience
Class of Equipment
Type of Equipment (tank, Van, Flat)
From
To
Approximate Number of Miles
Straight Truck
Tractor and Semi-Trailer
Tractor w/Doubles or Triples
Other
 
Education
Choose highest grade completed: High School: College
 
Experience and Qualifications
Show any trucking, transportation or other experience that may help in your work for this company:
 
List courses and training other than shown elsewhere in this application:
 
A.
Have you ever had any type of motor vehicle license suspended or revoked, or evern been denied a license, permit of privilege to operate a motor vehicle?
  Reason:
B.
Do you have a pending charge or past conviction for driving while intoxicated?
 
Application Addendum

Federal Motor Carrier Safety Rugulations §40.25 (j): The employer must ask the employee whether he or she has tested positive,
or refuded to test, on any drug or alcohol test administered by an employer to which the employee worked or applied for safety-
sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past three years.

 
Have you tested positive, or refused to test, on any drug test or have you tested .02 or greater, or refused to test, on any alcohol test
during the past three years?
 
TO BE READ AND SIGNED BY APPLICANT
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 all liability in respoinding to inquireis and releasing information in connection with my application. In the event of
employment, I understand that false or misleading information givien in my application or inerview(sO may result in discharge. I
understand, also, that I am required to abide by all rules and regulations of the Company. I understand that informationh I provide
regarding current andor prvious employers may be used, and those employer(s) will be contacted, for the purpose of investigating my
safety performance history as required by 49 CFR 391.23 (d) and (e).
 
I understand that I have the right to:
• Review information provided by previous employers;
• Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected
information to the prospective employer; and
• Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the
accuracy of the information.
 
By clicking on the submit button below I acknowlegde that the submission of this form acts as my signature.