Driver Application Home Driver Application Driver applicatioFirst NameLast NameAddressStatePhone/MobileEmailDate of BirthSocial Security NumberPrevious EmploymentEmployer nameAddressPhone/MobilePosition heldDates of employment Reason for leaving.Driving Experience DetailsTypes of vehicles operatedTypes of freight hauledSpecific endorsements usedGaps in Employment (if any)Explanation for periods of unemployment.License InformationCurrent CDL Information:License numberState of issuanceExpiration dateEndorsementsPrevious Licenses (Last 3 Years)States and license numbersReasons for changes (e.g., moved states).Driving RecordAccidents (Last 3 Years):Date of accident.Nature of the accidentNumber of injuries or fatalitiesViolations and Convictions (Last 3 Years)Traffic ticketsDUI/DWI incidentsSuspensions or RevocationsMedical CertificationCurrent DOT Medical Card InformationExpiration dateIssuing physician detailsDrug and Alcohol Testing ConsentWork AuthorizationProof of Eligibility to Work in the U.S.E-Verify consent form.Immigration and Visa StatusCriminal BackgroundDisclosure of Felonies or Misdemeanors (Last 7-10 Years)Nature of charges.Disposition or outcome.Consent for Background Check.ReferencesProfessional References:Namesjob titlesphone numbersRelationshipsCertifications and TrainingCertificationsDetails of CDL training schools or other relevant programsAdditional Disclosures and AgreementsFMCSA Compliance ConsentAgreement to abide by FMCSA regulationsAcknowledgment of At-Will Employment (if applicable)Authorization for Previous Employer ContactDate / TimeSignatureSubmit Form
