Ward Truckload Express, LLC: Driver's Application

"Ward Truckload Express, LLC: Driver's Application"

TRACTOR TRAILER DRIVERS ONLY
Ward Truckload Express, LLC is an equal opportunity employer.
We will not discriminate on the basis of sex, race, color, creed, national origin, age, disability or any other characteristic protected by federal, state or local law.

Please Complete All Fields
Date
First Name
Middle Name
Last Name
Social Security No.
Street Address
City
State
Zip
Home Phone
E-Mail Address
How long at present address ?
Position applied for (check one):	Lease Operator
Who referred you?
Are you at least 23 years of age?	Yes No
If no, do you have the necessary work permits and/or licenses for the position for which you are applying?
NOTE: Federal Regulations require that drivers in Interstate Commerce be at least 21 years of age.

Date of Birth (Full Date Required)
Have you worked for this company before?
Where?
DATES:	FROM: TO:
Position:
Reason for leaving: DRIVERS LICENSE INFORMATION
STATE
LICENSE NO.
CLASS
ENDORSEMENTS
EXPIRATION DATE

A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Yes No

B. Has any license, permit or privilege ever been suspended or revoked ?
Yes No

IF THE ANSWER TO EITHER "A" OR "B" IS YES, PLEASE GIVE DETAILS

DRIVING EXPERIENCE

Class of Equipment	Type of Equipment (Van, Tank, Flat, Etc.)	Dates From/To	Approx. No. of Miles (Total)
Straight Truck
Tractor & Semi-Trailer
Tractor - Two Trailers
Other

LIST STATES OPERATED IN FOR LAST TEN YEARS

LIST SPECIAL COURSES OR TRAINING THAT WILL HELP YOU AS A DRIVER

WHICH SAFE DRIVING AWARDS DO YOU HOLD AND FROM WHOM?

ACCIDENT/INCIDENT RECORD FOR THE PAST 10 YEARS OR MORE

	Dates	Nature of Accident (head-on, rear-end, upset, etc)	Fatalities	Injuries
Last Accident
Next Previous
Next Previous
Next Previous
Next Previous

TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 10 YEARS

(OTHER THAN PARKING VIOLATIONS)

Location	Date	Charge	Penalty

EMPLOYMENT HISTORY

NOTE:

D.O.T. Requires that Employment for Past 10 Years Be Shown

**NOTE:

May we contact this employer ? Yes No

PRESENT EMPLOYER

Employer Name
Phone
Address
Position Held
Dates From / To
Type of Work
Reason for Leaving

PAST EMPLOYERS

**NOTE:

May we contact these employers ? Yes No

1. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

2. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

3. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

4. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

5. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

6. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

7. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

8. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

9. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

10. Employer Name

Phone

Address

Position Held

Dates
From / To

Type of Work

Reason for Leaving

Have you ever been known by another name in the course of your previous employment ? Yes No

If yes, what name(s)?

GENERAL INFORMATION

Have you ever been bonded? Yes No

Name of Bonding Company

Have you ever been refused a bond?
Yes No

If yes, why?

Have you ever been convicted of a criminal offense

other than a minor traffic violation? Yes No

If so, Date

Place

Nature:

(An affirmative answer will not automatically disqualify you from being considered as a candidate for
employment.)

Any job offer from Ward Truckload Express, LLC will be conditional upon receipt of a satisfactory criminal background check.

TO BE READ BY APPLICANT BEFORE SUBMITTING APPLICATION:

NOTICE TO APPLICANTS (Please read the following statements carefully)

I hereby affirm that the information provided on this application is true and
complete to the best of my knowledge. I also agree that falsified
information or significant omissions may disqualify me from further
consideration for employment and may be considered justification
for dismissal if discovered at a later date.
Yes No

I agree that the employer or their agents may investigate my background
to ascertain any and all information of concern to my record,
whether same is of record or not, and release employers and persons
named herein from all liability for any damages on account of
furnishing such information.
Yes No

I agree to furnish such additional information and complete such
examinations as may be required to complete my employment file.
Any physical examination will be required only after a conditional
offer of employment has been extended.
Yes No

I understand that screening tests for alcohol and illegal drug
use may be required before hiring and during employment at Ward
Truckload Express, LLC.
Yes No

I understand that the information in this application will be
used and that prior and present employers will be contacted for
purposes of investigation as required by 391.23 of the Motor Carrier
Safety Regulations.

I also understand that employment at Ward Truckload Express, LLC, if
offered, is for no definite term and it may be terminated, with
or without cause or notice, at any time at the convenience of
the terminating party. I further understand that this condition
can only be altered by a written contract of employment which
is specific as to all material terms and is signed by both the
President of the Company and me.

I hereby further acknowledge that I am expected to abide by all
Company rules and regulations, written or unwritten, promulgated
by the Company, my Manager, or my Supervisor, but that such rules
and regulations do not create a contract between me and the Company
or otherwise restrict the right of the Company to terminate my
employment. I understand and agree that any handbook which I may
receive will not constitute an employment contract, but will be
a statement of the Company's current policies.

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.
Yes No

DRIVERS LICENSE INFORMATION