Thank you for your interest in Snap-Rite Manufacturing.  Please complete the driver application below.

GENERAL INFORMATION:

Last Name:

First Name:

Middle Name:

Current Address:

City:

State:

Phone#:

Date of Birth:

(req) Can you provide proof of age?:

Are you prevented from lawfully becoming employed in this country because of VISA or Immigration?

Are you in the Armed Services?:

Pay Grade:

JOB INFORMATION:

Start Date?:

Desired Salary:

How long have you been OTR driver?:

Are you employed now?

If so, may we inquire of your present employer?

Ever applied to this company before?

WHERE?

WHEN?

Referred by:

EDUCATION:

Completed Education(grade/years):

Schools attended:

Additional Helpful Skills:

Driving Experience/Qualifications – if None:

Select Operated Equipment Type(s):
Straight Truck  
Tractor/Trailer  
Trctr/Dual Trailer  
Bus  
Motorcoach  
Tanker  
Flat Bed  
Other 

Licenses:
State1:

License No.:

Type:

Expire:

State2:

License No.:

Type:

Expire:

State3:

License No.:

Type:

Expire:

Accident record for past 3 years. If None

1. Date:

Nature:

Fatalities?

Injuries?

2. Date:

Nature:

Fatalities?

Injuries?

3. Date:

Nature:

Fatalities?

Injuries?

Traffic Convictions and forfeitures for past 3 years (except parking):

1. Date:

Location:

Charge?

Penalty?

2. Date:

Location:

Charge?

Penalty?

3. Date:

Location:

Charge?

Penalty?

List special training and safe driving awards:

Have you ever been convicted of a felony or served time in a correctional inst.?

If yes, please explain fully. Conviction of a crime is not an automatic bar to employment – all circumstances will be considered.

Have you ever been denied a license,permit, or privilege to operate a motor vehicle?

Has any license,permit,or privilege ever been suspended or revoked?

If yes describe:

Is there any reason you might be unable to perform the functions of the job for which you have applied?

If yes describe:

EMPLOYER HISTORY: (List below the last 3 employers – start with the last employer first)

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle.

Employer 1: Name

Salary:

Position:

Current Address:

City:

State:

Phone#:

Contact Person:

CDL required?:

Reason for Leaving:

Employer 2: Name

Salary:

Position:

Current Address:

City:

State:

Phone#:

Contact Person:

CDL required?:

Reason for Leaving:

Employer 3: Name

Salary:

Position:

Current Address:

City:

State:

Phone#:

Contact Person:

CDL required?:

Reason for Leaving:

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or ant size vehicle used to transport hazardous materials in a quantity requiring placarding.*

Applicant Authorization

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. 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 also understand that I am required to abide by all rules and regulations of the Company.

DATE:

Sign: