Commercial Driver Application


Company Information


Applicant Information


*If the above residence less than three years, list below all residences for the past three years below.
Yes
No
Yes
No


Education




Military Service


Yes
No
Yes
No
Yes
No


General


Yes
No
Yes
No


Driver Experience and Qualifications


The Federal Motor Carrier Safety Regulations (49CFR391.21 (b) (2) requires that driver applicants state their date of birth and SS #.


Physical History


The Federal Motor Carrier Safety Regulations (49CFR391 Subpart E) requires that all driver applicants pass certain physical tests before they are hired to drive a motor vehicle.
Yes
No
Yes
No


Alochol and Controlled Substance Statement


The Federal Motor Carrier Safety Regulations 49CFR40.25(j) requires all persons with applying for a driving position requiring a commercial drivers license to answer the following questions:
Yes
No
Yes
No
Yes
No


Driver's License Information


Driver's Licenses held in the past 3 years must be shown.
Yes
No
Yes
No
Yes
No


Driving Experience


Accident History
Accident review for the past 3 years.
Motor Vehicle Driving Record (MVR)
Traffic Convictions and Forfeitures for the past 3 years other than parking violations.


Employment Record


The Federal Motor Carrier Safety Regulations (49CFR391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years for a total of ten (10) years. Any gaps in employment must be explained.

Start with the last or current position, including any military experience, and work back. You are required to list the complete mailing address: street number, city, state and zip code.










Applicant Must Read and Sign


I certify that I have read and understand all of this employment application. It is agreed and understood that the employer or his agents may investigate the applicant’s background to ascertain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and other persons named herein from all liability for any damages on account of his 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 that are pertinent to the job.

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 information regarding my character, personal reputation, personal characteristics and mode of living. You are also being informed that reports verifying your previous employment, previous drug and alcohol test results, and your driving record may be obtained on you for employment purposes. These reports are required by Sections 382.413, 391.23, and 391.25 of the Federal Motor Carrier Safety Regulations.

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 or facts may result in my rejection or dismissal. If hired, I agree to abide by all the rules and policies of the employer.

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 acknowledge that submission of this form will act as my electronic signature
Date:

Connect with J & K Contracting

Whether you have a job in mind or would simply like to learn more about J & K Contracting, feel free to contact us today. We’re happy to answer any questions you may have and discuss how we can help your next project.
  Let's Talk
© 2019, J & K Contracting. All Rights Reserved.   |   Iowa Web Design by EDJE