Dedicated Transportation Solutions

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Apply for Driver Positions

Personal Info: First Name * Last Name * Current Home Address * City * State * Zip Code *
Years lived From: * To: * Age: * DOB * Email * Phone *

Three Years Previous Address: Previous Address 1 From: To: Previous Address 2 From: To: Previous Address 3 From: To:

Professional Info: Have you ever worked for this company before? Yes No If Yes, Give Dates? From: To: Physical Exam Expiration Date: Reason for Leaving
How many years of Tractor/Trailer experience have you had? Can you prove your previous work experience? Yes No Has your driver's license EVER been suspended, revoked, or restricted? Yes No If Yes, Explain:
Commercial Driver's License (CDL)? Yes No What State? List any endorsements to your CDL:

Education History Please select the Highest Grade Completed: Select the highest grade level for this grade:

Employment History:

Give a Complete Record of all employment for the past five years, including any unemployment or self employment.

1. Present or Last Employer Name: Address Phone Position Held: Employed From: To: Reason for Leaving:
Were you subject to the FMCSRs* while employed here? Yes No Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

2. Present or Last Employer Name: Address Phone Position Held: Employed From: To: Reason for Leaving:
Were you subject to the FMCSRs while employed here? Yes No Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

3. Present or Last Employer Name: Address Phone Position Held: Employed From: To: Reason for Leaving:
Were you subject to the FMCSRs* while employed here? Yes No Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

4. Present or Last Employer Name: Address Phone Position Held: Employed From: To: Reason for Leaving:
Were you subject to the FMCSRs* while employed here? Yes No Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

5. Present or Last Employer Name: Address Phone Position Held: Employed From: To: Reason for Leaving:
Were you subject to the FMCSRs* while employed here? Yes No Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No