Employment Online - DW Trucking

DW Trucking Driver Application

Name
Address
Email
Telephone
DOB

Drivers License Info:

DL #
DL Issuing State
DL Expiration Date
Have you ever had any drive’s license denied, suspended, revoked, or cancelled by any issuing state agency?
If yes, please explain:

Driving Violations and Accidents:

Have you had ANY driving violations in the last 3 years (personal or work related)?
If yes, please explain and include dates:

As a driver, have you been involved in ANY accidents in the last 3 years (personal or work related)?
If yes, please explain and include dates and report numbers if available:

Previous Job History: Starting with most recent

Employer #1
Dates of employment
Employer's Address
Supervisor
Were you subject to Federal Motor Carrier Safety Regulations during this period? Were you subject to 40 CFR part 40 controlled substance & alcohol testing during this period? Reason for Leaving

Employer #2
Dates of employment
Employer's Address
Supervisor
Were you subject to Federal Motor Carrier Safety Regulations during this period? Were you subject to 40 CFR part 40 controlled substance & alcohol testing during this period? Reason for Leaving

Employer #3
Dates of employment
Employer's Address
Supervisor
Were you subject to Federal Motor Carrier Safety Regulations during this period? Were you subject to 40 CFR part 40 controlled substance & alcohol testing during this period? Reason for Leaving

(If there are any gaps in employment between above jobs, please explain here.)

------------------------------------------------------------------------------------------------------------------ For driver applicants of commercial motor vehicles that require a Commercial Driver License (CDL) the applicant must disclose their controlled substance and alcohol status per the requirements of 49CFR part 40.25(j). As a prospective driver employee, you have the right to review information provided by previous employers. You have the right to have errors in the information corrected by the previous employers(s) and for that previous employer(s) to re-send the corrected information to the prospective employer; the right to have rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information. Driver employees who have previous Department of Transportation regulated employment history in the preceding three years, and wish to review previous employer provided investigative information, must submit a written request to the prospective employer, which may be done at any time, including when applying or as late as thirty (30) days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), the five (5) business day deadlines will begin when the prospective employer receives the requested safety performance history information. If the driver has not arranged to pick up or received the requested records within thirty (30) days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived their request to review the records. Certification:

“I certify 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.”