Apply for Class A CDL Truck Driver - Frac Sand Hauling

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Class A CDL Truck Driver - Frac Sand Hauling
ID:1001
Department:Trucking
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:
Supported formats: Word, PDF, RTF, Text, and HTML.
  - or Upload from:
 
 Frac Sand Experience - Driver
* Do you have pneumatic trailer experience?
Yes
No
* Have you hauled frac sand?
Yes
No
* If yes, how many years experience hauling frac sand?
0
1
2
3
4
5 or more
If yes, list the names of companies that you have hauled for:
Applicant Information
* Position Applying For:
Contractor
Driver
Contractor's Driver
* Date of Birth
(The Age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40
but less than 70 years of age.)
* Social Security Number
* Physical Examination Expiration Date


Current & Previous 3 Years' Addresses

* Address #1:
* From:
* To:
Address # 2:
From:
To:
Address #3:
From:
To:


* Have You Ever Worked For This Company Before?
Yes
No

If yes, give dates:

From:
To:
Reason For Leaving:
Education History
* Please Select the Highest Grade Completed:
1
2
3
4
5
6
7
8
9
10
11
12
Some College
Associate's Degree
Bachelor's Degree
Post Graduate
10 Year Employment History
Give a COMPLETE RECORD of all employment for the past ten (10) years, including any unemployment or self-employment periods, and all commercial driving experience for the past ten (10) years.

Present or Most Recent Employer

* Employer's Name:
* From:
* To:
* Employer's Address:
* Phone:
* Position Held:
* Reason For Leaving:
* Were you subject to the FMCSRs while employed here?
Yes
No
* Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Yes
No

Employer #2

Employer's Name:
From:
To:
Employer's Address:
Phone:
Position Held:
Reason For Leaving:
Were you subject to the FMCSRs while employed here?
Yes
No
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Yes
No

Employer #3

Employer's Name:
From:
To:
Employer's Address:
Phone:
Position Held:
Reason For Leaving:
Were you subject to the FMCSRs while employed here?
Yes
No
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Yes
No

Employer #4

Employer's Name:
From:
To:
Employer's Address:
Phone:
Position Held:
Reason For Leaving:
Were you subject to the FMCSRs while employed here?
Yes
No
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Yes
No

Employer #5

Employer's Name:
From:
To:
Employer's Address:
Phone:
Position Held:
Reason For Leaving:
Were you subject to the FMCSRs while employed here?
Yes
No
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Yes
No

Employer #6

Employer's Name:
From:
To:
Employer's Address:
Phone:
Position Held:
Reason For Leaving:
Were you subject to the FMCSRs while employed here?
Yes
No
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Yes
No

Employer #7

Employer's Name:
From:
To:
Employer's Address:
Phone:
Position Held:
Reason For Leaving:
Were you subject to the FMCSRs while employed here?
Yes
No
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Yes
No
Driving Experience

Straight Truck

From:
To:
Approximate Number of Miles

Tractor & Semi-Trailer

From:
To:
Approximate Number of Miles

Tractor & Two Trailers

From:
To:
Approximate Number of Miles

Tractor & Triple Trailers

From:
To:
Approximate Number of Miles

Other

From:
To:
Approximate Number of Miles


* List states operated in, for the last five (5) years:
List special courses/training completed (PTD/DDC, HAZMAT, ETC)
List any Safe Driving Awards you hold and from whom


Accident Record for past three (3) years: (attach sheet if more space is needed):

Accident #1

Date of Accident:
Nature of Accident (Head on, rear end, etc)
Location of Accident:
Number of Fatalities:
Number of People Injured:

Accident #2

Date of Accident:
Nature of Accident (Head on, rear end, etc)
Location of Accident:
Number of Fatalities:
Number of People Injured:

Accident #3

Date of Accident:
Nature of Accident (Head on, rear end, etc)
Location of Accident:
Number of Fatalities:
Number of People Injured:

Accident #4

Date of Accident:
Nature of Accident (Head on, rear end, etc)
Location of Accident:
Number of Fatalities:
Number of People Injured:


Traffic Convictions and Forfeitures for the last three (3) years (other than parking violations):

Conviction/Forfeiture #1

Date:
Location:
Charge:
Penalty:

Conviction/Forfeiture #2

Date:
Location:
Charge:
Penalty:

Conviction/Forfeiture #3

Date:
Location:
Charge:
Penalty:

Conviction/Forfeiture #4

Date:
Location:
Charge:
Penalty:

Conviction/Forfeiture #5

Date:
Location:
Charge:
Penalty:


Driver’s License (list each driver’s license held in the past three(3) years:

License #1

* State
* License:
* Type:
* Endorsements:
* Expiration:

License #2

State
License:
Type:
Endorsements:
Expiration:

License #3

State
License:
Type:
Endorsements:
Expiration:

License #4

State
License:
Type:
Endorsements:
Expiration:

License #5

State
License:
Type:
Endorsements:
Expiration:


* 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
* Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the job description)?
Yes
No
* Have you ever been convicted of a felony?
Yes
No
If the answers to any questions listed above are “yes”, give details
Job References
List three (3) persons for references, other than family members, who have knowledge of your safety habits.

Reference #1:

* Name:
* Address:
* Phone:

Reference #2:

* Name:
* Address:
* Phone:

Reference #3:

* Name:
* Address:
* Phone:
To Be Read and Signed by Applicant:
*
It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty.

It is agreed and understood that the motor carrier or his agents may investigate the applicant’s background to obtain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and person named herein from all liability for any damages on account of his furnishing such information.

It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.

I agree to furnish such additional information and complete such examinations as may be required to complete my application file.

It is agreed and understood that this Application in no way obligates the motor carrier to employ or hire the applicant

It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse.

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.
Yes
No

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