Service Tech Application Step 1 of 9 11% Applicant's InformationLegal Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Phone* CDL Driving Record InformationDriver's License Number* State Issued* Driver's License Class*Class AClass BClass CClass DEndorsements* Select All H (Hazardous Materials) N (Tank Vehicle) P (Passenger) S (School Bus) T (Doubles & Triple Trailers) Expiration* Driving Record Status?*CleanOtherReason Have you ever received a Driving Under Influence (DUI) Violation?*YesNo Employment StatusAre you legally eligible for employment in the United States*YesNoHave you been convicted of a felony?*YesNoAre you 25 years or older?*YesNoWhich products have you previously transported? How many years of transportation driving experience do you have? Driver Position InformationWhat is your desired salary? What hours are you available to work?* If hired, when could you start?* Employment Status DesiredFull TimePart TimeTemporarySafety QuestionnaireIf you have a load on the truck that needs to be moved to its destination and you discovered a mechanical defect that is not DOT compliant, but is not dangerous enough to make you feel unsafe. Would you:* Call dispatch to see if he says to proceed to stop Try to correct problem and continue Shut truck down until all repairs have been made Finish load then make necessary repairs Employment HistoryPlease list job history with the most recent first.Employer* Job Title or Duties* Dates of Employment* Employment Status* Full Time Part Time Temporary Supervisor's Name Supervisor's Phone Number May we contact your previous supervisor? Yes No Employment History (continued)Employer Job Title or Duties Dates of Employment Employment Status Full Time Part Time Temporary Supervisor's Name Supervisor's Phone Number May we contact your previous supervisor? Yes No Employment History (continued)Employer Job Title or Duties Dates of Employment Employment Status Full Time Part Time Temporary Supervisor's Name Supervisor's Phone Number May we contact your previous supervisor? Yes No EducationType of School (List Highest Rank) High School/GED College/University Graduate School Tech School Name and Location Dates Attended Did you graduate? Degree Received Do you have any special courses, training or experience acquired, including military experience? Certification & AuthorizationConsentI hereby certify that all statements made in this application are true and correct to the best of my knowledge and belief. I understand that any misrepresentations or omissions of facts in this application are grounds for disqualification from further consideration or for dismissal from employment. I authorize the company to inquire into my educational, professional, and past employment history references as needed to research my qualifications for this position. If employed, I agree to conform to the rules, regulations, and policies of the company. I understand that I will be an employee “at-will” and either the company or I may terminate my employment relationship at any time for any reason not in violation of the law. I hereby acknowledge that I have read and fully understand the foregoing and seek employment under these conditions. I agree.