P.O. BOX 487  ASHFORD, AL 36312
800-633-7590, ext.116   Fax 334-899-8412

(Please call for comments or questions)

DRIVERS APPLICATION FOR EMPLOYMENT
 

In compliance with Federal and State equal employment opportunity laws, qualified applicants  are considered for all positions without regards to race, color, religion, sex, national origin, age, marital status, or non-job related disability.

Date: 

Position(s) applied for: 

Name:  Social Security Number:

List your addresses of residency for the past 3 years.

Current Address: 

Street:     City:   

State:   Zip: Phone:

Previous Address 1: 

Street:     City:   

State:    Zip:

Previous Address 2: 

Street:     City:   

State:    Zip:

Previous Address 3: 

Street:     City: 

State:      Zip:

Do you have the legal right to work in the United States? Yes  No

Date of Birth:    Can you provide proof of age?  Yes No

Have you worked for this company before?  Yes No  

If yes, where? 

Dates employed:  from to

Rate of Pay    Position: 

Reason for Leaving: 

Are you now employed?  Yes No   If not, how long since your last employment:

Who referred you: 

Rate of pay expected:

Is there any reason you might be unable to perform the functions of the job for
which you have applied as described in the job description?  Yes No

If yes, please explain if you wish:
 

 

 

 

 

Text Box:  

EMPLOYER (most recent)

DATE

NAME:

FROM(Mo./Yr)

TO (Mo/Yr)

ADDRESS:

POSITION HELD

CITY:

ST: 

ZIP:

SALARY/WAGE
  

CONTACT PERSON:

PHONE:

REASON FOR LEAVING
  
.

EMPLOYER

DATE

NAME:

FROM(Mo./Yr)

TO (Mo/Yr)

ADDRESS:

POSITION HELD

CITY:

ST: 

ZIP:

SALARY/WAGE
  

CONTACT PERSON:

PHONE:

REASON FOR LEAVING
  
.

EMPLOYER

DATE

NAME:

FROM(Mo./Yr)

TO (Mo/Yr)

ADDRESS:

POSITION HELD

CITY:

ST: 

ZIP:

SALARY/WAGE
  

CONTACT PERSON:

PHONE:

REASON FOR LEAVING
  
.

EMPLOYER

DATE

NAME:

FROM(Mo./Yr)

TO (Mo/Yr)

ADDRESS:

POSITION HELD

CITY:

ST: 

ZIP:

SALARY/WAGE
  

CONTACT PERSON:

PHONE:

REASON FOR LEAVING
  
.

EMPLOYER

DATE

NAME:

FROM(Mo./Yr)

TO (Mo/Yr)

ADDRESS:

POSITION HELD

CITY:

ST: 

ZIP:

SALARY/WAGE
  

CONTACT PERSON:

PHONE:

REASON FOR LEAVING
  
.

EMPLOYER

DATE

NAME:

FROM(Mo./Yr)

TO (Mo/Yr)

ADDRESS:

POSITION HELD

CITY:

ST: 

ZIP:

SALARY/WAGE
  

CONTACT PERSON:

PHONE:

REASON FOR LEAVING
  

 


 

 

 

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION

DATE

CHARGE

PENALTY

 

 

 

 

 

 

 

 

Explanation:

EDUCATION

What is the highest grade level completed?

 Elementary (1-8):

High School (1-4):

College (1-4):

Name of Last School Attended:

 

 

EXPERIENCE AND QUALIFICATIONS – DRIVER

DRIVERS

LICENSES

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 either A or B is YES, Give Details below:

DRIVING EXPERIENCE: IF NONE, WRITE NONE

CLASS OF EQUIPMENT

TYPE OF EQUIPMENT

FROM (MO/YR)

TO (MO/YR)

APPROX. NO. OF MILES (TOTAL)

Straight Truck

 

 

Tractor and Semi-Trailer

 

Tractor – Two Trailers

 

Motor Coach – School Bus

 

Other: 

List States operated in for the last five(5) years:

 Show special courses or training that will help you as a driver?

Which safe driving awards do you hold and from whom?

  EXPERIENCE AND QUALIFICATIONS – OTHER


Show any trucking, transportation or other experience that may help in your work for this company:

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):

 .

Accident record for the past 3 years or more (attach sheet if more space is needed). If none, write none.

DATES

NATURE OF ACCIDENT
(HEAD-ON, REAR-END,
UPSET, ETC.)

FATALITIES

INJURIES

Last Accident:  

Next Previous: 

 

Next Previous:  

 

 

 

 

 

 

 

 

 

 

 

TO BE READ AND SIGNED BY APPLICANT

By entering my name below and submitting, this certifies that I completed this application, 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 investigations and inquires 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.

               Applicant’s Name:      Date   mailto:dbanner@amxtrucking.com