CDL Job Application

In compliance with federal and state equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or the presence of non-related job medical condition of handicap. All motor carriers regulated under Federal Motor Carrier Safety Regulations must meet the requirements of Title 49 CFR Part 391 and Part 382 as they apply to qualifying the applicant for a driving position.

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Your Personal Information

Your Name*

First Middle Last

Phone*

Your Email Address*

Enter Email Confirm Email

Position(s) You're Applying For*

Who referred you?

Date of Birth*

Social Security Number

* Date of birth and Social Security number are required on a DOT driver application by 49 CFR §391.21(b)(2).

If hired, will you be able to provide documentation sufficient to establish authorization to work in the United States?*

Addresses for past three years

Current Address*

Street Address Unit / Suite Number City State Zip Code

Months at this address

Previous Address

Street Address Unit / Suite Number City State Zip Code

Months at this address

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Are you now employed*

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How long since leaving last employment?*

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Rate of pay expected*

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Have ever been bonded?

Answer only if a job requirement

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Name of bonding company*

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List any reasons you might be unable to perform the functions of the job for which you are applying

Employment History

List ALL employers during the 3 years preceding this application. If applying to operate a CMV requiring a CDL under 49 CFR Part 383, also list employers for the additional preceding 7 years for which you operated a CMV (10 years total of applicable history). Include dates of employment and reason for leaving.

Your Previous Employers*

Name

Address

Dates Worked

Position/Duties

Phone

Reason for Leaving

Subject to FMCSRs²

Safety-sensitive Function³

² The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and used to transport hazardous materials in a quantity requiring placarding.

³ Was your job designated as a safety-sensitive functions in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR part 40?

Check here to indicate that all required driving history where your drove a vehicle weighing more than 26,001 lbs. GCVWR, or was designed to carry 16 or more passengers including the driver, or which transported hazardous materials in placardable quantities for the period describe above has been included in this application*

I have included all required driving history

Accident Record for Past 3 Years

Have you had any accidents in the past 3 years?*

List of Accidents*

Date

Nature of Accident

Fatalities

Injury

Hazardous Material Spill

Motor Vehicle Violations - Preceding 3 Years

List all motor vehicle law/ordinance violations (other than parking-only violations) for which you were convicted or forfeited bond/collateral during the 3 years preceding this application

Have you had any motor vehicle violations in the past 3 years?*

List of Violations*

Date

Violation

State / Jurisdiction

Penalty / Disposition

Experience & Qualifications

Valid licenses currently held.

Commercial Driver License / Permit Information*

Issuing Authority / State

License/Permit Number

Type / Class

Endorsement / Restrictions

Expiration Date

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

B) Has any license, permit or privilege ever been suspended or revoked?*

If you answered "yes" to question A or B, explain the details:

Driving Experience

Examples for Type: Van, Tank, Flat, etc.

Straight Truck

Type

From

Miles

Tractor and Semi-Trailer

Type

From

Miles

Tractor - Two Trailers

Type

From

Miles

Tractor - Tanker

Type

From

Miles

Other

Type

From

Miles

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Motor Coach - School Bus (more than 15 passengers)

Type

From

Miles

List States Operated in for Last 5 Years*

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List special courses or training that will help you as a driver

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Which safe driving awards do you hold and from whom?

Education & Job-Related Training

Do not provide dates of attendance or graduation.

High School / GED

School / Training Provider & Locations

Course of Study / Training

Degree / Certificate / Credential

College

School / Training Provider & Locations

Course of Study / Training

Degree / Certificate / Credential

Trade / Technical / Other

School / Training Provider & Locations

Course of Study / Training

Degree / Certificate / Credential

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

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List courses and training other than shown elsewhere on this application

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List special equipment or technical materials you can work with (other than those already shown)

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Highest Grade Completed*

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Last School Attended (Name, City, State)

Terms and Conditions

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 understand that the employment information I provided in the Employment History section of this application may be used, and my previous employers will be contacted, for the purpose of investigating my safety performance history information as required by 49 CFR 391.23(d) and (e). I authorize Zwald Transport, Inc. and its agents to contact my former employers for the purpose of fulfilling the requirements of the 49 CFR Parts 391.22 and 382.413. I further authorize Zwald Transport, Inc. and its agents to make any such additional inquires beyond the FMCSR minimum requirements that are necessary to qualify this application. I do hereby release Zwald Transport, Inc., its agents and any of my former employers from any and all liability which may result from obtaining and/or furnishing such information. I have received a copy of and been advised of my rights under 49 CFR 391.23(h) and (i) review information provided by previous employers upon submitting a written request within 30 days after being notified of denial of employment, (ii) have errors in information corrected, and (iii) have a rebuttal statement attached to allege erroneous information.

Acceptance*

I agree to the Terms and Conditions

Electronic Signature*

Date*