Drivers Application for Employment

Driving Experience (If none, write none)
*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.

Class of Equipment *

	Type of Equipment (Van, Tank, Flat)	Dates (From and To)	Approx. # of Miles
Straight Truck
Tractor and Semi-Trailer
Tractor-Two Trailers
Motor coach/School Bus
Other

List states operated in the last five years: *
List special courses or training that will help you as a driver:
Which safe driving awards do you and hold and from whom?

TECHNICAL, PROFESSIONAL, MANAGERIAL SKILLS

Show any trucking, transportation or other experience that may help in your work for this company. List special equipment, technical material you can work with, training abilities or noteworthy achievements (other than those already shown). 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 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)
In accordance with §391.21, Application for Employment this section may be used for the purpose of investigating your background as required by §391.23, investigation and inquiries.
Employer: *
Phone Number *

Area Code Phone Number
Job Title *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Dates Employed: *
To:
Dates Employed: *
From:
May we contact for reference? *

Yes No
Summarize the type of work performed and job responsibilities: *
Employer: *
Phone Number *

Area Code Phone Number
Job Title *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Dates Employed: *
To:
Dates Employed: *
From:
May we contact for reference? *

Yes No
Summarize the type of work performed and job responsibilities: *
Employer: *
Phone Number *

Area Code Phone Number
Job Title *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Dates Employed: *
To:
Dates Employed: *
From:
May we contact for reference? *

Yes No
Summarize the type of work performed and job responsibilities: *

Education

	Name of School	Location	Course of Study	No. of Years Completed	Did you graduate	Diploma/Degree
Grammar School
High School
College
Other

SUBSTANCE ABUSE SCREENING NOTICE
The Company maintains drug-free workplaces. This means that we do not permit the use of any illegal substances at any of our locations. It also means that we will not employ any person who tests positive for Illegal drugs. Your initial and continued employment by the Company, therefore, is contingent upon, among other things your successfully passing our drug-screening process.
PLEASE READ AND SIGN THIS SECTION
I certify that this application was completed by me. I certify that all of the Information contained in this Application or any other document I have submitted to the Company is true and accurate to the best of my knowledge. Understand that If any of this information is false, incomplete or misleading, it may be grounds for rejection of my application for employment.
Furthermore, I understand that if false, incomplete, or misleading information is discovered after I have been employed
by the Company, such discovery may be cause for the termination of my employment.
By submitting this application and/or any other documents, I agree to comply with the Company's rules and regulations. I further understand that If hired and where permissible by law, l will be an "at-will" employee, that is, my employment and compensation will not be for a definite period and my employment can be terminated at any time by me or by the Company with or without cause of prior notice, regardless of the successful completion of any introductory or probationary period. I further understand that no recruiter, Interview, or other representative of the Company, other than an officer of the Company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the forgoing and none has done so.
I certify that I have received a written notification that the Company may obtain a consumer report or reports on me. I authorize this Company to obtain such a report or reports for use In connection with my application for employment and for other employment-related reasons. If hired, this authorization shall remain on file and serve as ongoing authorization for procurement of employment-related consumer reports at any time during my employment. I understand that the term "consumer report"' includes, but is not limited to, credit checks, criminal background checks, department of motor vehicle reports, and investigative consumer reports. I further understand that the term "investigative consumer report"' means a report in which information on my character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with my neighbors, friends, or associates, or with others with whom I am acquainted or who may have knowledge concerning any such items of information.
I understand and agree as a condition of employment or continued employment that I will be required to take a pre-employment substance abuse test, take a substance abuse and/or alcohol screening test at any time where the Company determines
there is probable cause to do so, and that the test results must be satisfactory to the Company. I also agree to take a post-offer medical examination if requested. Understand that any offer to hire is conditioned upon results satisfactory to the Company
of any required pre-employment test, substance abuse test, background investigation, and Company medical examination or Inquiries.
Although management makes every ·effort to accommodate individual preferences, business needs may at times make the following conditions mandatory: overtime, shift work, or a rotating work schedule that includes Saturday and Sunday. I understand and accept these, if hired, as conditions of my continued employment.
DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND THIS STATEMENT
Signature: Sign with mouse *

Clear
Date: *

DRUG & ALCOHOL CLEARINGHOUSE CONSENT FOR LIMITED QUERIES

NOTICE TO DRIVER: The Commercial Driver’s License (CDL) Drug & Alcohol Clearinghouse is a federal database containing information about CDL drivers who have violated the Federal Motor Carrier Safety Administration’s (FMCSA’s) drug or alcohol regulations in 49 CFR Part 382. Whether you have committed such a violation or not, each motor carrier for whom you drive is required to check whether the Clearinghouse has any information about you, both at the time of hire and annually. When conducting an annual inquiry, the motor carrier has the option to request a “limited” report that only indicates whether the Clearinghouse has any information about you. Before a motor carrier may request a limited report, they must have your written authorization, per §382.701(b). This authorization may be valid for more than one year. If a limited query ever reveals that the Clearinghouse has information about you, you will be required to log in to the Clearinghouse website within 24 hours to grant electronic consent for the motor carrier to obtain your full Clearinghouse record.

NOTICE TO MOTOR CARRIER: This consent form authorizes you to run a “limited query” to check whether the Clearinghouse has information about the driver identified below. If it does, then you must obtain a full Clearinghouse record within 24 hours, per §382.701(b). This consent form must be retained until 3 years after the date of the last limited query you perform for this driver, based on the authorization below.
I,
*

First Name Last Name
hereby authorize DIAMOND MATERIALS to conduct limited annual queries of the FMCSA’s Drug & Alcohol Clearinghouse, to determine if a Clearinghouse record exists for me. This consent is valid from the date shown below until my employment with the above-named motor carrier ceases or until I am no longer subject to the drug and alcohol testing rules in 49 CFR Part 382 for the above-named motor carrier.

I understand that if any limited query reveals that the Clearinghouse contains information about me, I must grant electronic consent within 24 hours, via the Clearinghouse website, for the motor carrier to obtain my full Clearinghouse record. Refusal to provide such consent will result in my removal from safety-sensitive duties.
Signature *

Clear
Date *

Month Day Year
Date
Please upload any files you would like us to see:

Browse Files

Cancel of

Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform