Employment Application
Applicant Information
Education
References
please list three professional references.
Driving Experience
What is your accident record for the past three years? Please list if there are any accidents that are still pending.
( Attach additional sheets as needed).
Please list any traffic convictions or forfeitures for the past three years. Please list any tickets that are still pending (Other than parking violations).
For availability please place an “X” for day available and underneath the day place a time. If you
are available all day that day please place just an “X” for that day.
*Non CDL* Previous Employment for the last (3) years
Military Service
If other than honorable, explain:
Disclaimer and Signature
I certify that my answers are true and complete to The best of my knowledge. I understand that any information provided by me that is found to be false, incomplete or misrepresented it any respect, will be sufficient cause to (i) eliminate me from further
consideration for employment, or (ii) may result in my immediate discharge from the employers service, whenever it is discovered. I understand that this employer does not unlawfully discriminate in employment and no question is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law. If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the right to terminate my employment at any time with or without cause and with or without prior notice, except required by law. This application does not constitute an agreement or contract for employment for any specified period or duration. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an 1-9in this regard.