Driver Application for Employment
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. Please fill out the application as best you can. Standard contact information is required.

Position(s) Applying for:
Over The Road
Local Tractor-Trailer
Local Straight-Truck
Van

First Name
 Middle Name
 Last Name
Social Security#
 DateofBirth:
 Can you provide proof of age?
Current residence and contact information
Address:


City:


State:


Zipcode:


Phone:


Email Address:
 Previous Address
(If current address is less than three years please provide previous information)
How Long?


Address:


City:


State:


Zipcode:

EDUCATION
Choose highest grade completed
High School
College
Last School Attended
Location of School
Have You Ever Taken a Truck Driving School?   
If Yes, Did You Graduate?
Name of School
Address of School
Date Gradutated
Show special courses or training that will help you as a driver:
Which Safe Driving Awards Do You Hold and From Whom?

EMPLOYMENT INFORMATION

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years.

Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 10 years of information on those employers for whom the applicant operated such vehicle.

*Includes vehicles having a GVWR of 26,001 lbs. Or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.
Have you worked for CMAC before?
 From:
 To:
Position:
 Reason for leaving:
Who referred you?
 Rate of Pay Expected
Are you currenlty employed?

PREVIOUS EMPLOYMENT
Employer 1


Address


Telephone # (s)


Job Title


Supervisior


Date Employed From:
 Employer 2


Address


Telephone # (s)


Job Title


Supervisior


Date Employed From:
 Employer 3


Address


Telephone # (s)


Job Title


Supervisior


Date Employed From:

EXPERIENCE - DRIVER QUALIFICATIONS

State
 License No.
 Type
 Airbrake?
 Expiration Date
Have you ever been denied a license or permit to operate a vehicle?
Has Any License, Permit or Priviledge Ever Been Suspended or Revoked?
Have You Ever Been Convicted of a Felony?

EXPERIENCE - EQUIPMENT
Class of Equipment Type of Equipment
(Van, Tank, Flat, Etc.) 		Date From Date To Approx. No. of Miles (TOTAL)
Straight Truck
Tractor/Trailer
Semi Doubles
Other

EXPERIENCE - OTHER QUALIFICATIONS
Show Any Trucking, Transportation or Other Experience That May Help in Your Work for This Company
List Any Courses and Training Other Than Shown Elsewere in This Application
List Special Equipment or Technical Materials You Can Work With (Other Than Those Already Shown)

ACCIDENT RECORD FOR PAST THREE YEARS OR MORE
Date
Date
Date