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Personal Information
First Name:     ......
Middle:
Last Name:
Address:
City:
State:
Zip Code:
Home Phone:
Other Phone:
Pager:  Ext:
Social Security:
Email Address:
How did you hear about us?:
 
Drivers License and Safety Information
License Number:
Expires:
State Issued:
Birthdate:
CDL License Class: A B C D None
Do You Have A Hazardous 
Material Endorsement?		  Yes  No 
Have you ever had your license revoked or suspended?  Yes  No 
Have you had any accidents 
in the last 3 years?		  Yes  No 
Have you had any tickets in the last 3 years?  Yes  No 
Have you been convicted of DWI, DUI or BAC in the last 5 years?  Yes  No 
Have you ever been convicted 
of a felony?		  Yes  No 
Have you ever been convicted 
of a crime?		  Yes  No 

If you answered 'Yes' to any of the last 6 questions 
please give details below.

 
Driving Preferences
Select what you are most interested in working:
 Regional   Over-the-road
 Solo   Team   Husband/Wife Team
 
Driving School History
Name of Driving School:
Still in School?  Yes   No
If No Please Enter Graduation Date:
 
Equipment Profile :
Fill out ONLY if you currently own/lease equipment
Tractor Make:
Year of Tractor:
Tractor HP:
Type of Trailer:
 
Hauling Experience
Type Trained Years Miles
Intermodal/Container Transport Yes No
Van Yes No
Reefer Operation Yes No
HazMat Hauling Yes No
 
Present Employer
Company Name:
Address:
City:
State:
Zip Code:
Contact Name:
Phone Number:
Employment
Dates:  		  From: 
     To: 
Position Title:
Pay Rate:                   
Reason for Leaving:
 
Previous Employer 1
Company Name:
Address:
City:
State:
Zip Code:
Contact Name:
Phone Number:
Employment
Dates:  		  From: 
     To: 
Position Title:
Pay Rate:
Reason for Leaving:
 
Previous Employer 2
Company Name:
Address:
City:
State:
Zip Code:
Contact Name:
Phone Number:
Employment
Dates:  		  From: 
     To: 
Position Title:
Pay Rate:
Reason for Leaving:
 
Previous Employer 3
Company Name:
Address:
City:
State:
Zip Code:
Contact Name:
Phone Number:
Employment
Dates:                       		  From: 
     To: 
Position Title:
Pay Rate:
Reason for Leaving:
 
COMMENTS
 
IMPORTANT!!! READ BEFORE APPLYING
FMCSR NOTICE FOR DRIVER APPLICANTS
It is expressly acknowledged, understood and agreed that the information provided by the applicant regarding the applicant's employment during the previous three (3) years in accordance with Section 391.21(b)(10) of the Federal Motor Carrier Safety Regulations ("FMCSR") may be used, and the applicant's prior employers may be contacted, for the purpose of investigating the applicant's safety performance history information as required by paragraphs (d) and (e) of Section 391.23 of the FMCSR. The applicant has certain due process rights under the FMCSR regarding the information received as a result of these investigations, as described below.

Applicant's Due Process Rights:

    1. The right to review information provided by previous employers
    2. The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to TransPro Freightways; and
    3. The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

[ CLICK HERE ] to view DAC Dicsclosure Form.

I have read and understand these rights as well as having read the DAC Disclosure form *

 

 
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