BOWMAN TRUCKING Application for Employment

Application for Employment

BOWMAN TRUCKING, INC. IS AN EQUAL OPPORTUNITY EMPLOYER and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability or any other basis prohibited by law.
BOWMAN TRUCKING, INC.
61999 Quail Rd. La Grande, Oregon 97850
Office: 541-963-4663, 800-722-4465, Fax: 541-963-6638

The Company will maintain this Application in an active status for 60 days. If you want to be considered for employment after 60 days from the date of this Application, you must complete and submit a new Application.
Date

MonthDayYear
Date
Full Name*

First NameMiddle NameLast Name
Email Address*
Phone Number*

Area CodePhone Number
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
If at the above address less than three years, list below all residences for the past three years.
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position Applying For:
Position Type: (select all that apply)

TemporaryPart TimeFull Time
Who referred you?
Rate of pay requested?
Have you worked for this company before?
If yes, please list dates:
Where?
Rate of pay:
Position:
Reason for leaving:
Names of any relatives employed by this company
Are you currently employed?

yesno
If not, how long since leaving your last employment?

Education
Last grade completed:
Years of College
Did you attend Professional Truck Driving School?

yesno
If yes, please list the school name and location
Graduation Date

General
Have you ever been bonded?
Name of bonding company:
Have you ever been convicted of a crime other than a minor traffic violation?

yesno
If yes, please explain fully. Conviction of a crime is not an automatic bar to employment.
Have you ever been convicted of a crime or felony involving a motor carrier or any aspect of the motor carrier industry?

yesno
If yes, please explain fully. Conviction of a crime is not an automatic bar to employment.
Have you ever worked for this company under another name?

yesno
If so, under what name?
Are you authorized to work in the United States?

yesno
Social Security Number
Please include dashes
Date of birth

MonthDayYear
The U.S. Department of Transportation requires that applicants state their date of birth (s 391.21(b)(2)

Driver Experience and Qualification

Licenses:

	STATE	LICENSE NO.	CLASS	ENDORSEMENT(S)	EXPIRATION DATE
1
2
3

A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?

yesno
B. Has any license, permit or privilege ever been suspended or revoked?

yesno
C. Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations?

yesno
If you answered ''yes" to A, B, or C please provide details.

Driving Experience:

	TYPE OF EQUIPMENT (Van, Tank, Flat, etc.)	FROM (Date)	TO (Date)	APPROX. TOTAL MILES
Class of Equipment
Tractor Trailer
Other

List states operated in during the last five years
List special courses or training that will help you as a driver
List driving awards and who awards were presented by

Accident Review for the last three years:

	NATURE OF ACCIDENT (Head-on, Rear-end, Overturn, etc.)	FATALITIES	INJURIES
Date of Last Accident
Date of Next Previous
Date of Next Previous

Traffic Convictions and Forfeitures for the past 3 years other than parking violations:

	LOCATION	DATE	CHARGE	PENALTY
1
2
3
4

Employment Record

Complete, accurate information must be provided.
Under the Federal Motor Carrier Safety Regulations (Section 391.23) Bowman Trucking, Inc. is required to verify the employment background of all prospective drivers for the preceding ten years. You must account for all periods of your employment history, or periods when you were not employed, which cannot be verified by any other means. Please fill in the dates and describe your activities during this (these) time(s).
1.
1. Period of Unemployment or Unverifiable Employment (if any):
2.
2. Period of Unemployment or Unverifiable Employment (if any):
3.
3. Period of Unemployment or Unverifiable Employment (if any):
Do you have additional Employment and/or Unemployment information to enter?

yesno
4.
4. Period of Unemployment or Unverifiable Employment (if any):
5.
5. Period of Unemployment or Unverifiable Employment (if any):
6.
6. Period of Unemployment or Unverifiable Employment (if any):
7.
7. Period of Unemployment or Unverifiable Employment (if any):
8.
8. Period of Unemployment or Unverifiable Employment (if any):
9.
9. Period of Unemployment or Unverifiable Employment (if any):
10.
10. Period of Unemployment or Unverifiable Employment (if any):

Applicant Must Read and Sign
I certify that I have read and understood all of this employment application. It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all infonnation of concern to my employment history, whether same is of record or not and I release employers and other persons named herein from all liability for any damages on account of furnishing such information. I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks, which are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of a physical examination and drug test.

I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason.

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

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

I also understand that the misrepresentation or omission of information or facts may result in my rejection or dismissal.

If hired, I agree to abide by all the rules and policies of the employer.

I EXPRESSLY ACKNOWLEDGE AND UNDERSTAND THAT IN THE ABSENCE OF WRITTEN CONTRACT TO THE CONTRARY, MY STATUS, IF I AM HIRED, WILL BE THAT OF AN EMPLOYEE AT WILL, HAVING NO CONTRACTUAL RIGHT, EXPRESS OR IMPLIED, TO REMAIN IN THE COMPANY'S EMPLOY. IN THIS CONNECTION, I EXPRESSLY ACKNOWLEDGE FURTHER THAT NEITHER ANYTHING SAID TO ME DURING THE COMPANY'S APPLICATION AND/OR INTERVIEW PROCESS OR DURING EMPLOYMENT NOR ANY PROVISION IN THE COMPANY'S POLICIES OR EMPLOYEE MANUAL CONSTITUTES THE TERMS OF AN EXPRESS OR IMPLIED EMPLOYMENT AGREEMENT. In consideration of any employment offered, I specifically agree that my employment may be terminated, with or without cause or notice, at any time, at the option of either the Company or myself. I understand that no unauthorized representative may enter into any agreement for employment or make any agreement contrary to the foregoing.
Today's Date*

MonthDayYear
Date
Applicant Signature*

Clear
Should be Empty:

Application for Employment

Education

General

Driver Experience and Qualification

Employment Record

Applicant Must Read and Sign