DRIVER APPLICATION Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastSocial Security Number *Date of Birth *Email *Home Phone *Cell Phone *Street Address *City *State *Zipcode *Emergency Contact *FirstLastEmergency Contact Phone *Relationship To Applicant? *Have you lived anywhere else in the past 3 years? *YesNoDo you have the legal right to work in the United States? *YesNoHave you worked for W.S. Xpress Trucking Before? *YesNoHave you worked for Sanford Xpress Trucking before? *YesNoHave you worked for Williams & Son Trucking before? *YesNoWhat position are you applying for? *LocalRegionalOTRAre you employed now? *YesNoWho Referred You?FirstLastHighest level of education? (Check all that apply) *GEDGEDHigh School GraduateCollageTrade SchoolOtherWhich driving school did you attend? *School Address *Street AddressCity *State *Zip Code *School PhoneDate Completed? *Employer 1 *List your most recent employer.Street Address *City *State *Zip Code *Employer Contact *FirstLastPhone *Start Date *Departure Date *Reason for leaving? *Employer 2Street AddressCityStateZip CodeEmployer ContactFirstLastPhoneStart DateDeparture DateReason for leaving?Employer 3Street AddressCityStateZip CodeEmployer ContactFirstLastPhoneStart DateDeparture DateReason for leaving?Employer 4Street AddressCityStateZip CodeEmployer ContactFirstLastPhoneStart DateDeparture DateReason for leaving?Employer 5Street AddressCityStateZip CodeEmployer ContactFirstLastPhoneStart DateDeparture DateReason for leaving?Have you had any traffic violations in the past 3 years? *YesNoIf 'yes' to, please explain belowProvide location, date and charge of violation.Have you had any accidents in the previous 3 years? *YesNoIf 'yes', please explain belowProvide location, date and type of acident.If yes, were there any injuries? *YesNoIf yes, were there any fatalities?YesNoCDL License Number *State *Class *Endorsements *Expiration Date *Have you ever been denied a license, permit, or privilige to operate a motor vehicle? *YesNoHas any Iicense, permit, or privilege ever been suspended or revoked?YesNoIf 'yes' to either, please explain belowWhat type of equipment experience to you have? *Box TruckFlatbedRefrigeratedVehicle HaulerOtherIf other, please explain.Do you have any driving related awards or recognition? *YesNoList other experiences or skills that may help in your work for this companyHave you ever been convicted of a felony? (Answering 'yes' does NOT automatically disqualify you) *YesNoIf yes please explain.I certify that I have read and understood all of this employment application. lt is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employent history, whether same is of record or not, and I release employers and other persons named herein from all liability of 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 will be conditioned on the results of a physical examination and a 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 may include an investigative Consumer Report, including information 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 misrepresentation or omission of information of facts may result in my rejection or dismissal. lf hired, I agree to abide by all the rules and policies of the employer. 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.Signature *Date *Date / TimeDateTimeSubmit
