DRIVER APPLICATION

 
A * indicates required fields.
P
E
R
S
O
N
A
L
Last Name*
 First*
 Middle*
Date*
Street Address*
Home Telephone*
City*
 State*
 Zip*
Business Telephone*
Have you ever applied for employment with us?*
Yes No
Social Security # *
If yes, Month and Year: Location:

 
Drivers License Information
Date of Birth*
Drivers License # *
 State*
 Exp. Date*
Are you over 23 years of age?*
Yes   No
Endorsements
Is your Current License a CDL class?*
Yes   No
Combination vehicles over 26,001 lbs?*
Yes   No
Hazardous Materials?*
Yes   No
Air brakes?*
Yes   No
Experience Level
Years Van?
Years Reefer?
Years Other?
Have you EVER been denied a license, permit or privilege to operate a motor vehicle ?*
Yes   No
Have you EVER had a license, permit or privilege suspended or revoked ?*
Yes   No
Have you EVER been convicted of driving while under the influence of alcohol or drugs ?*
Yes   No
Have you EVER been convicted of a crime ?*
Yes   No
Have you EVER been disqualified to drive by Federal Regulations ?*
Yes   No
Have you EVER been refused as security bond ?*
Yes   No
If you answered yes to any of these questions, please state the details, circumstances and date:
Accident Information
Have you had any accidents in the past three years? Yes   No
1
Date
Nature of accident
Injuries? Yes   No
2
Date
Nature of accident
Injuries? Yes   No
3
Date
Nature of accident
Injuries? Yes   No
Traffic Violations (past three years)
1
Date
State
Offense
Penalty
2
Date
State
Offense
Penalty
3
Date
State
Offense
Penalty
Employment History (past three years)
1
Company Name
Telephone
Address
Employed - (State month and year)
From To
Name of Supervisor
Weekly Pay
Start Last
State Job Title and Describe Your Work:
Reason for Leaving:
2
Company Name
Telephone
Address
Employed - (State month and year)
From To
Name of Supervisor
Weekly Pay
Start Last
State Job Title and Describe Your Work:
Reason for Leaving:
3
Company Name
Telephone
Address
Employed - (State month and year)
From To
Name of Supervisor
Weekly Pay
Start Last
State Job Title and Describe Your Work:
Reason for Leaving:
References (List Three)
1
First and Last Name
Telephone
Company
Position
2
First and Last Name
Telephone
Company
Position
3
First and Last Name
Telephone
Company
Position
I understand that John Christner Trucking is a drug free work place, and at the companies discretion, random drug testing will be required.

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.

I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.

If you decide to engage in investigative consumer reporting agency on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.

I agree that my employment and compensation can be terminated, with or without cause, and with or without notice. At any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its President, and then only when in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.


 
I understand by sending this application I am authorizing JCT and/or it agents to verify any of the information I have provided, including but not limited to, criminal history and motor vehicle records. I understand by doing so that I am authorizing JCT to sign my name to release forms as required.

By submitting this application online you agree to the above said terms and conditions.

If you have any questions regarding driver employment email DebbiePollock@johnchristner.com