Hauling, dump trucks and transportation services in Watts, OK

Applicant Information

Date *

First Name *

MI

Last Name *

Address History (Past 3 Years)

Current Address

Street Address *

City *

State/Zip *

How Long?

Previous Address #2

Street Address

City

State/Zip

How Long?

Previous Address #3

Street Address

City

State/Zip

How Long?

Contact & Personal Information

Daytime Phone *

Evening Phone

Date of Birth *

Social Security Number *

CDL Number *

State *

Expiration Date *

General

Position Applying For *

Full Time or Part Time *

Educational Background

Last Grade of School Completed *

How Did You Learn About This Position?

Person

Other

Emergency Contacts

Emergency Contact #1

Name *

Relationship

Telephone *

Emergency Contact #2

Name

Relationship

Telephone

Employment History

List your previous employers beginning with your most recent. Provide history for the past ten years. Explain any gaps.

May we contact your current employer? *

Yes No

Employer #1 (Most Recent)

Employer Name *

Position/Title

Address

City & State

Telephone

Salary/Wage

Start Date

End Date

Reason for Leaving

Subject to DOT Regulations?

Yes No

Authorization & Background

Authorized to work in the US? *

Yes No

Ever been convicted of a felony?

Yes No

License Information

Do you have a valid driver's license? *

Yes No

License ever denied, suspended, or revoked?

Yes No

Driving Experience

Equipment Class	Equipment Type (Van, Flat, etc.)	Miles Driven
Straight Truck
Tractor & Semi-Trailer
Tractor - Two Trailers
Other

States operated in during the last 5 years:

Special courses or training:

Safe driving awards:

Other special equipment or technical materials:

Accident Record (Past 3 Years)

List most recent accident first.

Accident #1

Date

Nature of Accident

Fatalities

Injuries

Traffic Convictions (Past 3 Years)

Do not list parking violations.

Conviction #1

Date

City & State

Charge

Penalty

DOT Drug & Alcohol Testing

Pursuant to Federal Motor Carrier Regulations CFR 40.25(j):

Have you tested positive or refused to test on any pre-employment drug or alcohol test during the past 2 years? *

Yes No

Your Understanding & Agreement

I understand that I may be denied employment or terminated if the information I provide is not completely truthful.
I authorize GARMAN TRUCKING LLC to verify all information and contact anyone with knowledge about me.
I understand that GARMAN TRUCKING LLC is an Equal Employment Opportunity employer.
I understand my rights concerning information from previous employers regarding DOT recordable accidents and alcohol/controlled substance violations:
1. The right to review information provided by previous employers;
2. The right to have errors corrected and re-sent;
3. The right to have a rebuttal statement attached if accuracy cannot be agreed upon.

I certify that this application was completed by me, and that all entries are true and complete to the best of my knowledge. *

Consent to Background Investigation

I authorize my previous employer to release information to GARMAN TRUCKING LLC as required by Section 391.3, FMSCR. The previous employer is released from any liability resulting from furnishing this information.

Printed Name *

Date *

Digital Signature (Type Full Name) *

GARMAN TRUCKING LLC

Employment Application for Drivers

Applicant Information

Address History (Past 3 Years)

Current Address

Previous Address #2

Previous Address #3

Contact & Personal Information

General

Educational Background

How Did You Learn About This Position?

Emergency Contacts

Emergency Contact #1

Emergency Contact #2

Employment History

Employer #1 (Most Recent)

Authorization & Background

License Information

Driving Experience

Accident Record (Past 3 Years)

Accident #1

Traffic Convictions (Past 3 Years)

Conviction #1

DOT Drug & Alcohol Testing

Your Understanding & Agreement

Consent to Background Investigation

Application Submitted Successfully!

About Garman Trucking LLC