Address For Past Three Years

    Do you have the legal right to work in the United States yesno
    Are you over the age of 18
    If no can you provide proof of age yesno
    Have you worked for this company before yesno
    Are you now employed

    Is there any reason you might be unable to perform the functions of the job for which you have applied
    (as described in the attached job description)yesno

    Employment History

    Employer One

    Employer Two

    Employer Three

    Employer Four

    Military Status

    Have You Served in the U.S Military


    Highest Grade Completed

    Experience and Qualifications - Platform

    Experience and Qualifications - Maintenance

    Hydraulic Air Brakes yes
    Sheet Metal Equipment yes
    Clutch Rebuild yes
    Transmission Rebuilding yes
    Body Work yes
    Frame & Axle Straightening Equipment yes
    Electrical & Ignition Troubleshooting/Repair yes
    Engine Rebuilding yes
    Diesel Injection Equipment yes
    Electric Welder yes
    Oxyacetylene Welder yes
    Chassis Dynamometer yes
    Inspection License yes
    Computer Knowledge yes
    Other yes
    Forklift Certification yes
    Parts/Warehouse Distribution yes
    Tire Repair yes
    Engine Dynamometer yes
    List Courses and Training in Maintenance Work

    Experience and Qualifications - Clerical

    Payroll Processing yes
    Account Receivables yes
    Account Payables yes
    Dispatching yes
    Dispatching Software yes
    GPS Software yes
    Truck Weight/Trip Permitting yes
    Driver Payroll Calculationyes
    Routing Software yes
    Training Other Staff yes
    Computer Skillsyes
    DOT/OSHA/CSA yes
    Receptionist/Greeter yes
    Billing yes
    Customer Service yes
    List Courses and Training in Maintenance Work

    Experience and Qualifications - Other

    To be read and signed by applicant

    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.

    As part of the application process, I am aware that certain prequalification procedures are involved. This may include a driving test, classroom attendance and other pre hiring examinations. I understand and agree that during this period I am not an employee of the company, and I am not entitled to receive any pay or compensation for my time spent in these procedures. No such testing by the Company shall be deemed to be a hiring until such time as I receive written notification from a Company official.

    I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

    In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.