JOB OPPORTUNITIES

Instructions: Please complete the following form and click "Submit".

DRIVER'S 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, veteran status, non-job related disability, or any other protected group status.

  
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N.O. RESIDENT INFO		  

Personal Information:

  
Application Date:
Last Name:
First Name:
Middle Initial:
SS#
Position Applied For:
Address:  
City::  
State:  
Zip  
   

List your addresses of residency for the past 3 years:
Current Address Street:  
Current Address City:  
Current Address Zip:  
Current Address Phone:  
Length of time at current residence:  

Previous Address 1
Previous Address Street:
Previous Address City:
Previous Address Zip:
Length of time at this residence

Previous Address 2
Previous Address Street
Previous Address City
Previous Address Zip:
Length of time at this residence

Previous Address 3
Previous Address Street:
Previous Address City:
Previous Address Zip:
Length of time at this residence:
 
Do you have the legal right to work in the United States?  
Can you provide proof of age?  
Have you ever worked for this company before? Yes    No
If yes, where?
If yes, start date?
If yes, end date?
If yes, pay rate?
If yes, position?
If yes, reason for leaving?
Are you currently employed? Yes    No
If no, how long since last employment?
Who referred you?
Rate of pay expected:
Have you ever been bonded? (Answer only if job requirement)
Name of bonding company:
Have you ever been convicted of a felony?:
If yes, explain:
Is there any reason you might be unable to perform the functions of the job for which you have applied?: Yes    No
If yes, explain if you wish::

YOUR FORMER EMPLOYERS
 

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state, and zip code.

Applicants to drive a commercial motor vehicle in intrastate or interstate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operated such vehicle. (NOTE: List employers in reverse order starting with the most recent. Add another sheet as necessary.)

*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.
 
Name of Last Employer:
Address:
City:
State:
Zip:
Starting Date:
Ending Date:
Job Title:
Weekly Starting Salary:
May We Contact Your Supervisor: Yes    No
Name of Supervisor:
Title:
Phone:
Description of Work:
Reason for Leaving:
Did you drive a vehicle requiring a CDL?: Yes    No
 
Name of Last Employer:
Address:
City:
State:
Zip:
Starting Date:
Ending Date:
Job Title:
Weekly Starting Salary:
May We Contact Your Supervisor: Yes    No
Name of Supervisor:
Title:
Phone:
Description of Work:
Reason for Leaving:
Did you drive a vehicle requiring a CDL?: Yes    No
 
Name of Last Employer:
Address:
City:
State:
Zip:
Starting Date:
Ending Date:
Job Title:
Weekly Starting Salary:
May We Contact Your Supervisor: Yes    No
Name of Supervisor:
Title:
Phone:
Description of Work:
Reason for Leaving:
Did you drive a vehicle requiring a CDL?: Yes    No
 
Name of Last Employer:
Address:
City:
State:
Zip:
Starting Date:
Ending Date:
Job Title:
Weekly Starting Salary:
May We Contact Your Supervisor: Yes    No
Name of Supervisor:
Title:
Phone:
Description of Work:
Reason for Leaving:
Did you drive a vehicle requiring a CDL?: Yes    No
 
Name of Last Employer:
Address:
City:
State:
Zip:
Starting Date:
Ending Date:
Job Title:
Weekly Starting Salary:
May We Contact Your Supervisor: Yes    No
Name of Supervisor:
Title:
Phone:
Description of Work:
Reason for Leaving:
Did you drive a vehicle requiring a CDL?: Yes    No
 
Name of Last Employer:
Address:
City:
State:
Zip:
Starting Date:
Ending Date:
Job Title:
Weekly Starting Salary:
May We Contact Your Supervisor: Yes    No
Name of Supervisor:
Title:
Phone:
Description of Work:
Reason for Leaving:
Did you drive a vehicle requiring a CDL?: Yes    No
   

ACCIDENT RECORDS

Accident records for past 3 years or more (attach sheet if more space is needed) If none, write NONE.
Date, Nature of Accident(Head-On,Rear-End, Upset, Etc), Fatalities, Injuries of Last Accident:
   
Date, Nature of Accident(Head-On,Rear-End, Upset, Etc), Fatalities, Injuries of Last Accident:

 
   
Date, Nature of Accident(Head-On,Rear-End, Upset, Etc), Fatalities, Injuries of Last Accident:
   

TRAFFIC CONVICTIONS

And forfeitures for the past 3 years (other than parking violations) If none, write NONE.
Location, Date, Charge, & Penalty of Last Traffic Conviction:
   
Location, Date, Charge, & Penalty of Last Traffic Conviction:
   
Location, Date, Charge, & Penalty of Last Traffic Conviction:

EDUCATION

Highest Level Completed:  
High School Grade Completed:  
College Level Completed:  
Last School Attended
(name & city)		  

DRIVERS LICENSES

State, License No, Type, Expiration Date:
   
State, License No, Type, Expiration Date:
   
State, License No, Type, Expiration Date:
A.)  Have you ever been denied a license, permit, or privilege to operate a motor vehicle? : Yes    No
B.)  Has any license, permit, or privilege ever been suspended or revoked: Yes    No
If the answer to A or B is yes, give details:

DRIVING EXPERIENCE (If none, write "NONE")

Straight Truck (Type of Equipment, From/To Date, Approx Number of Total Miles):
   
Tractor and Semi-Trailer (Type of Equipment, From/To Date, Approx Number of Total Miles):
   
Tractor-Two Trailers (Type of Equipment, From/To Date, Approx Number of Total Miles):
   
Motorcoach - Schoolbus (Type of Equipment, From/To Date, Approx Number of Total Miles):
   
Other (Type of Equipment, From/To Date, Approx Number of Total Miles):
   
List states operated in for last five years:
   
Show special courses or training that will help you as a driver:
   
Which safe driving award do you hold and from whom?:

EXPERIENCES AND QUALIFICATIONS - OTHER
Show any trucking, transportation, or other experience that may help in your work for this company: Date, Approx Number of Total Miles):
   
List courses and training other than shown elsewhere in this application:
   
List special equipment or technical materials you can work with (other than those already shown):

To be read and signed by applicant

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

I authorize you to make such investigation 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.
DATE:  
SIGNATURE (ENTER NAME):  
   

Copyright © 2010 Metro Disposal Service. All rights reserved.
Revised: 08/16/11.