Driver Application Step 1 of 4 25% Employment ApplicationName* First Middle Last Address* Street Address City State / Province / Region ZIP / Postal Code Position Applied ForDate You Can Start MM DD YYYY Previous 3 Years AddressesPhone*Social Security Number*Date Of Birth* MM DD YYYY Desired Salary* Employment History - List Most Recent First (Please provide information for all employers in the preceding 10 years)1 - Employer*Job Title*Address* Street Address City State / Province / Region ZIP / Postal Code Supervisor*Office #*Cell #Summarize your work/job responsibilities*What did you like the most?*What did you like the least?*Reason for leaving*Start Date Employed* Date Format: MM slash DD slash YYYY End Date Employed* Date Format: MM slash DD slash YYYY Compensation Start $*Compensation End $*Safety Sensitive Function* Yes No Subject to Part 40 (Drug & Alcohol Test)?* Yes No 2 - Employer*Job Title*Address* Street Address City State / Province / Region ZIP / Postal Code Supervisor*Office #*Cell #Summarize your work/job responsibilities*What did you like the most?*What did you like the least?*Reason for leaving*Start Date Employed* Date Format: MM slash DD slash YYYY End Date Employed* Date Format: MM slash DD slash YYYY Compensation Start $*Compensation End $*Safety Sensitive Function* Yes No Subject to Part 40 (Drug & Alcohol Test)?* Yes No 3 - Employer*Job Title*Address* Street Address City State / Province / Region ZIP / Postal Code Supervisor*Office #*Cell #Summarize your work/job responsibilities*What did you like the most?*What did you like the least?Reason for leaving*Start Date Employed* Date Format: MM slash DD slash YYYY End Date Employed* Date Format: MM slash DD slash YYYY Compensation Start $*Compensation End $*Safety Sensitive Function* Yes No Subject to Part 40 (Drug & Alcohol Test)?* Yes No Have you had any gaps in employment of more than 4 months duration during the past 10 years?* Yes No If yes, explainHave you ever been fired or asked to resign?* Yes No If yes, explainHave you ever applied for a job with this company before?* Yes No If yes, explain when and for what position Educational BackgroundHighSchoolAddress City State / Province / Region Graduated WithGraduation Date MM DD YYYY College, Business, or Technical SchoolAddress City State / Province / Region Major/MinorDate MM DD YYYY List any special training, skills, licenses, and/or certificates that may assist you in performing the position for which you are applyingDriving Information*StateLicense NumberClass & EndorsementExpiration Date Have you ever been denied a license, permit, or privilege to operate a motor vehicle?* Yes No Has any license, permit, or privilege ever been suspended or revoked?* Yes No If yes, explain whyHave you ever been arrested for DUI/drunk driving?* Yes No Ever been convicted of, or pled guilty or no contest to a misdemeanor or felony?* Yes No Positive substance abuse or alcohol test?* Yes No Used illegal drugs within the past 10 years?* Yes No Straight Truck(Van, Tank, Flat Etc)ToFromApprox No. of MilesTractor & Semi TrailorType of Equipment (Van, Tank, Flat Etc)ToFromApprox Number of MilesTractor - Two TrailersType of Equipment (Van, Tank, Flat Etc)ToFromApprox Number of MilesOtherType of Equipment (Van, Tank, Flat Etc)ToFromApprox Number of MilesAccident Record For The Past 3 YearsDateNature of Accident (Head-on, Rear End, Upset, etc)FatalitiesImjuries Traffic Convictions And Forfeitures For The Past 3 YearsDateLocationChargePenalty ReferencesName* First Last Phone #*Relationship*Name* First Last Phone #*Relationship*Name* First Last Phone #*Relationship*Other InformationWill you work overtime if required?* Yes No Can you abide by a no smoking policy?* Yes No Ever filed for bankruptcy protection or been sued for collection of debt?* Yes No Do you participate in any volunteer activities benefiting the local community?* Yes No If yes, explainWhat type of hobbies or activities do you enjoy in your free time?*Upload Your ResumeI hereby certify and affirm that all information provided above is true and correct. I hereby authorize verification of all information provided in this application, including financial and credit information, via credit bureas and/or contact with current and previous employers, current and previous landlords and personal references.I agree with and authorize Elk Transport in accordance with the terms listed above.* Yes No
