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Please complete all sections and click the SUBMIT APPLICATION button at the bottom or you can email your resume to employment@teamwws.com.

We are an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.

First Name:

           

Last Name:

Social Security Number:

           

Phone:

Email:

Address:

City:

        

State:

        

Zip:

        

Years at Residence:

Sex:

       

Height:

       

Weight:

       

Date of Birth:

       

# of Dependants:

Check One:
Single    Engaged    Married    Separated    Divorced    Widowed

In Case of Emergency Notify:

        

Address

        

Phone:



MILITARY STATUS

Have you served in the U.S. Armed Forces?

Branch

        

Date From:

        

Date To:



EDUCATION

High School:


City:

           

State:

           

Zip:

Number of years completed:


Did you graduate?:


College / University:


City:

           

State:

           

Zip:

Number of years completed:


Did you graduate?:



EXPERIENCE & QUALIFICATIONS - DRIVER

Drivers License Number:

           

State:

           

Type:

           

Expires:

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 You Answered Yes to either question please explain:


EMPLOYMENT HISTORY

Do you have a valid safety card? :
              Do you have a T.W.I.C. card? :

Have you been employed as a driver by other Motor Carriers prior to date of this application?:


Are you currently employed?:


If you are currently employed, may we contact your current employer?:


Below, please describe past and present employment positions, dating back five years. Most recent first.

Name of Employer:


Name of Supervisor:


Telephone Number:


City:

           

State:

           

Zip:

Length of Employment (Include Dates):


Position & Duties:


Reason for Leaving:


May we contact this employer?:



Name of Employer:


Name of Supervisor:


Telephone Number:


City:

           

State:

           

Zip:

Length of Employment (Include Dates):


Position & Duties:


Reason for Leaving:


May we contact this employer?:




Name of Employer:


Name of Supervisor:


Telephone Number:


City:

           

State:

           

Zip:

Length of Employment (Include Dates):


Position & Duties:


Reason for Leaving:


May we contact this employer?:



ACCIDENT RECORD

List all accidents in which you were involved as a driver during the preceding 3 years.

Date:

           

Nature:

          

# of Fatalities:



          



          





          



          





WORK INJURY RECORD

List all personal injuries suffered by you that were job connected, and give the following information pertaining to each injury; if none so state:

Date:

       

Employer:

      

Type:

      

Compensated:



      



      



      

Compensated:



      



      



      

Compensated:


CRIMINAL HISTORY

List all violations of motor vehicle law or ordinances (other than violations involving only parking) of which you were convicted or forfeited bond or collateral during the 3 years preceding date of this application.

Date:

       

Type:

      

Location:



      



      





      



      





Have you ever been convicted of a felony?:


If yes please explain:



PLEASE READ & SIGN BELOW

I understand that the information in this application will be used and that prior employers will be contacted for purpose of investigation as required by 391.23 of the Motor Carrier Safety Regulations. (Initial)

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company. (Initial)

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company. (Initial)

Applicant's Signature:

            Date: