Personal and Contact Information:

First Name MI   Last Name

Home Phone Alternate Phone

Email address Social Security #

Date of Birth Height Weight

Driving Experience and Information:

List any drivers licenses held in the past five years:

   State               License Number              Expiration

Are you a driving school graduate? Choose... Yes No

How many years of truck driving experience do you have? 

Have you ever been convicted of a felony? Choose... Yes No   If yes, please explain, including date(s) of incident(s):

Have you ever had a reckless or careless driving ticket? Choose... Yes No   If yes, please explain, including date(s) of incident(s):

Has your license ever been suspended or revoked?  Choose... Yes No   If yes, please explain, including date(s):

Please list any moving violations (if any) that have occurred in the past 3 years:

Please list any vehicle accidents (if any) that have occurred in the past 5 years:

Date available to begin work

Work History (Past 10 Years)  Please list most recent first

NOTE:  D.O.T. Requires that Employment for at least 10 years be shown

To be read, initialed, and dated by applicant

Applicants are considered without regard to race, color, age, religion, sex, marital status, national origin, citizenship, handicap, disability or any other status protected under federal or state law.

It is agreed and understood that this application for employment is subject to approval and acceptance of corporate headquarters personnel located in Sycamore, Alabama.  I understand and acknowledge that such acceptance and approval is necessary before I will be employed by the company.

It is agreed and understood that the information in this application will be used and that prior employers will be contacted for purposes of investigation as required by 391.23 of the Motor Carrier Safety Regulations.

It is agreed and understood that any misrepresentations of information given above shall be considered an act of dishonesty.

It is agreed and understood that the employer or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information.

It is agreed and understood that the employer or his agents may obtain a consumer report which may contain public record information from DAC Services, Tulsa, Oklahoma.  This report may include the following types of information:  names and dates of previous employers, reason for termination of employment, work experience, accidents, etc.  I further understand that such report may contain public record information concerning my driving record, workers' compensation claims, credit, bankruptcy proceedings, criminal records, etc., from federal , state, and other agencies which maintain such records; as well as information from DAC concerning previous driving record requests made by others from such state agencies, and state provided driving records.  As such, I authorize, without reservation, any party or agency contacted by DAC or the employer to furnish the above-mentioned information.

It is also agreed and understood that under the Fair Credit Report Act, Public Law 91-508, I have been told that this investigation may include an Investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.

It is agreed and understood that, in connection with my application for employment (including contract for services), the employer or his agents may

I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.

It is agreed and understood that this application for employment in no way obligates the employer to employ me; and it is understood that if hired, I will be on a 90 day probationary period during which I may be discharged without recourse.

It is agreed and understood that I understand that this application is not an employment contract and that if hired, my employment and compensation can be terminated, with or without cause, at any time at the option of either the company or myself.

I certify that my answers to questions pertaining to physical history are correct and that if any answer is found to be false or inaccurate, my future employment is subject to termination without notice.

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.

If you agree with these terms, please indicate by typing I AGREE your initials and date

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To submit your online application, please click the "Submit" button below ONCE.  Please note that clicking "Reset" will clear the form completely.