Employee Application

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Employment Application

  • 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, veteran status, non-job related disability, or any other protected group status.
  • 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 responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. I understand that information I provide regarding current and/or previous 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 I have the right to:
  • • Review information provided by previous employers.
  • • 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.
  • • 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.
 

Personal Information

 

Position Interest

 

Education

 

Skills

 

Work Classification

    Give years of experience in each classification

 

Drivers License and Driving Information

 

Personal References

    Reference 1

    • Reference 2

 

Past Employment Information

  • All applicants must provide the following information on all employers during the past three (3) years. Applicants to drive a commercial motor vehicle shall also provide an additional seven (7) years information. Complete mailing address, street number, city, state, and zip code are required. There can be no gaps in employment.

    • Employer 1

    • Employer 2

    • Employer 3

 

Traffic Convictions and Forfeitures

  • Only complete this section if you will be asked to drive for Diesel Dogs Trucking. If you are asked to drive for Diesel Dogs Trucking Service you are required to list any traffic violations you have had in the past 3 years. I certify the following is a true and complete list of traffic violations (other than parking tickets) for which i have been certified or forfeited bond or collateral.

    • Violation 1

    • Violation 2

    • Accident 1

    • Accident 2

  • * Convictions are not an absolute bar to employment, but will be considered in relationship to the job requirements.
 

CDL License

  • Complete this portion of the application if you have a CDL or have operated a commercial motor vehicle.
  • Please list all address you have resided during the past three (3) years.

    • Address 1

    • Address 2

    • Driving Experience

 

Affirmative Action Voluntary Information

  • This company is committed to an Affirmative Action Program which includes giving full consideration for employment to qualified handicapped individuals, Vietnam-era veterans, disabled veterans, ethnic minorities and women. The following information is being requested for all applications for employment. Your providing this information is strictly VOLUNTARY. This self-identification request is made in compliance with the AFFIRMATIVE ACTION PROGRAM and to aid in complying with any required Governmental record keeping or periodic reporting. This information is NOT part of your employment application, and will not be considered in the employment selection process. If you choose to provide the information please complete the following:
 

TO BE READ AND SIGNED BY APPLICANT

  • I authorize you to make sure investigations and inquiries to 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 responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. “I understand that information I provide regarding current and/or previous 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 current/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.”
  • This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.
  • Note: A motor carrier may require an applicant to provide information in addition to the information required by the Federal Motor Carrier Safety Regulations.
 

Verify

 
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