Driver Application Form Part 1
Instructions
You have been emailed a link to Part 1 of the application. Should you have to exit the process due to time constraints or to verify information, you may use this link to return to this section of the app and all previously entered information will be saved. ***We strongly suggest that you verify all info BEFORE you submit. Once submitted, all saved fields related to the link will be cleared*** If you realize you need to update something after you have already submitted, you will have to start this part of the app over again. Please put 10 years of employment history on application. We will need to verify at least the last 3 years of your employment; two of these three years must be driving. Please furnish good phone numbers for the last 5 years. Please sign release, fair credit, and the top part of the Safety Performance Sheet under the section labeled “Applicant”. We will be running both an MVR and a criminal check. You must not have more than 2 moving violations, or an accident and one moving violation in the last three years.
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Driver Application Form
How did you hear about us?
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Driver Application Form
What position are you applying for?
*
Company Driver
Leased Owner Operator / Independent Contractor
Either
Tractor(s) Information
*
Year / Make / Model
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Driver Application Form
What region(s) are you applying for? Select all that apply.
*
North Texas
South Texas
West Texas
East Texas
Southeast New Mexico
Ohio / Pennsylvania / West Virginia
Colorado
Oklahoma
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Driver Application Form
Personal Information
Name
*
First Name
Last Name
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Driver Application Form
Personal Information
Social Security Number
*
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Driver Application Form
Personal Information
Primary Phone #:
*
-
Area Code
Phone Number
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Driver Application Form
Personal Information
Secondary Phone #:
-
Area Code
Phone Number
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Driver Application Form
Personal Information
Date Of Birth:
*
-
Month
-
Day
Year
Date Picker Icon
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Driver Application Form
Personal Information
Email:
*
example@example.com
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Driver Application Form
Personal Information
Current Address:
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Other Addresses 1(Within Last 3 Years) :
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Other Addresses 2 (Within Last 3 Years):
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Driver Application Form
Drivers License Info
Drivers License #
*
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Driver Application Form
Drivers License Info
Drivers License State
*
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Drivers License Info
Drivers License Class
*
CLASS A
CLASS B
CLASS C
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Driver Application Form
Drivers License Info (Cont.)
Drivers License Expiration:
*
-
Month
-
Day
Year
Date Picker Icon
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Driver Application Form
Emergency Contact Information
Emergency Contact Name
First
Last
Emergency Contact Phone Number
-
Area Code
Phone Number
Emergency Contact Relationship
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Driver Application Form
Driving Experience
Type of Equipment
*
Years Experience
*
Miles Driven
*
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Driver Application Form
Driving Experience (Cont. 1)
Type of Equipment
Years Experience
Miles Driven
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Driver Application Form
Driving Experience (Cont. 2)
Type of Equipment
Years Experience
Miles Driven
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Driver Application Form
Driving Experience (Training)
Do you have PEC (Safeland) Training ?
*
Yes
No
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Driver Application Form
Driving Experience (Training Cont.)
Do you have Hydrogen-Sulfide (H2S) Training?
*
Yes
No
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Driver Application Form
Accident Record (Last 10 Years)
I have not been involved in an accident in the last 10 years
Accident Record 1
Date
-
Month
-
Day
Year
Date Picker Icon
Accident Record 2
Date
-
Month
-
Day
Year
Date Picker Icon
Accident Record 3
Date
-
Month
-
Day
Year
Date Picker Icon
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Driver Application Form
Traffic Convictions (Last 3 Years)
I have not been convicted of a traffic violation in the last 10 years
Citation History 1
Date
-
Month
-
Day
Year
Date Picker Icon
Citation History 2
Date
-
Month
-
Day
Year
Date Picker Icon
Citation History 3
Date
-
Month
-
Day
Year
Date Picker Icon
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Driver Application Form
License & Criminal Background
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
*
Yes
No
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Driver Application Form
License & Criminal Background
Have you ever been arrested and/or convicted of a misdemeanor or felony?
*
Yes
No
If yes, please explain fully. Conviction of a crime is not an automatic bar to employment, all circumstances will be considered.
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Driver Application Form
License & Criminal Background
Has any license, permit or privilege ever been suspended or revoked?
*
Yes
No
If you answered "Yes" to the questions above, please provide details:
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Driver Application Form
Employee Drug & Alcohol Abuse History
Employee Alcohol and Drug Statement
EMPLOYEE ALCOHOL AND DRUG STATMENT Sec. 40.25(j) As the employer, you must also ask the employee whether he or she has tested positive, or refused to test, on any pre-employment drug and alcohol test administered by an employer to which the employee applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years. If the employee admits that he or she had a positive test or a refusal to test, you must not use the employee to perform safety-sensitive function for you, until and unless the employee documents successful completion of the return-to-duty process (See 40.25(b)(5) and (e)) * The employee is required by Sec. 40.25 to respond to the following question:
Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years?
*
Yes
No
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Driver Application Form
Family Employees
Do you have any family members working for SandBox Logistics or U.S. Silica Organization?
*
Yes
No
If Yes, Who?
Full Name
Relationship To Applicant?
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Driver Application Form
Mandatory PSP Driver Consent Form Statement
Authorization
*
Signature
*
Date
*
-
Month
-
Day
Year
Date Picker Icon
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Driver Application Form
Drug And Alcohol Abuse Policy Statement
Authorization
*
Signature
*
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Driver Application Form
Fair Credit Reporting Act Disclosure Statement
Authorization
*
Signature
*
Date
*
-
Month
-
Day
Year
Date Picker Icon
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Driver Application Form
General Consent Authorization
Authorization
*
Signature
*
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Driver Application Form
Applicant Information Statement
Authorization
*
Signature
*
Enter the message as it's shown
*
Submit Application Part 1
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