COMMERCIAL DRIVER APPLICATION

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APPLICANT INFORMATION

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Current and Previous Three Years Addresses:
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If yes, give dates:
 
Education History:
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EMPLOYMENT HISTORY

Give a COMPLETE RECORD of all employment for the past three (3) years, including any unemployment or self employment periods, and all commercial driving experience for the past ten (10) years.
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DRIVING EXPERIENCE
 
 
 

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JOB REFERENCES

List three (3) persons for references, other than family members, who have knowledge of your safety habits.
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TO BE READ AND SIGNED BY APPLICANT

It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty.
It is agreed and understood that the motor carrier or his agents may investigate the applicant’s background to obtain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and person named herein from all liability for any damages on account of his furnishing such information.
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 investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.
I agree to furnish such additional information and complete such examinations as may be required to complete my application file.
It is agreed and understood that this Application in no way obligates the motor carrier to employ or hire the applicant.
It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse.
This certifies 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.
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Disclosure Under Fair Credit Report Act and Consent to Procurement of Consumer Report for Employment Services

The undersigned hereby authorizes the R&R Concrete & Supply, R&R Ready Mix, Inc., or Arquette Concrete & Supply, Inc. or its insurance agency, or its assigns to obtain copies of consumer reports, including a motor vehicle report, pertaining to me for employment purposes, and for use in rating and or underwriting insurance for which the above named employer may apply, and my renewal thereof. I understand that in obtaining such consumer reports, a consumer reporting agency may be used, and I do hereby such use.
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