Application for Independent Contractor

Driver

Years at this address

If the current address less than 7 years.

Which Terminal are you applying for? (name of person you spoke with about the position, and/or location of terminal)

How did you hear about us? If a driver referred you please tell us their name so we may thank them!:

Commercial Driver's License

Name - Exactly as it appears on your driver's license

Maiden or other name used

Years of CDL Experience

Issuing State/Province

Driving/ Hauling Experience

Switching (yard tractor)

What year did you first obtain your Class A Drivers license? If you do not know the exact year please estimate...:

Please estimate how many total miles you have driven Tractor Trailers in the last 2 years?

List ALL additional licenses held in the past 5 years and ALL unexpired commercial motor vehicle operator's licenses or permits. (Click on the Plus sign to add additional Licenses.) DO NOT enter current license information in this section.

Accident Review For Past 5 Years

No Accidents to report.

Description (head-on, rear-end, overturn, etc.)

Traffic Convictions & Forfeitures for Past 3 Years

No Traffic Convictions or Forfeitures to report.

Charges (other than parking violations)

DOT requires you to provide 10-years of employment history! Show all periods of unemployment and explain reasons for leaving each job. Begin with your present employer and work backwards down the page. Be sure to account for each month of your work experience and explain all periods of unemployment along with dates of unemployment. PLEASE ADD THE TYPE OF EQUIPMENT DRIVEN at each Company - (Tractor Trailer - Straight Truck, etc. )

Driving/Hauling Experience With This Employer

Were you subject to the FMCSRs while employed by this employer?

Driving/Hauling Experience With This Employer

Please list an emergency contact Name and phone number:

I hereby agree and consent to completing this application and background investigation process electronically. I understand that I will be signing this application and all forms related to this application electronically and that the electronic signatures appearing on these documents are the same as my handwritten signature for the purposes of validity, enforceability and admissibility. You have the right to withdraw your consent to sign electronically at any time by calling the number listed at the top of this page. You can print and retain a copy of any electronically signed documents by clicking on the PDF symbol in the top right corner of that document.

I hereby agree and consent to receiving SMS text messages requesting additional information and/or providing additional instructions regarding the application process, onboarding and/or my employment, if applicable. You have the right to withdraw your consent to receiving SMS text messages at any time by texting “STOP” in reply to any message you receive or by calling 833-655-0069-.

Previous Employer Inquiry For Driving History & Safety Performance

PSP Consent Form

Consent for Release of Info Form

Disclosure and Authorization Form

Pre-Employment Controlled Substance Consent Form

Fair Credit Reporting Act Consumer Rights

Drivers Rights Pertaining to Release of Information under Regulation 391.23

FMCSR Clearinghouse Limited Query Consent

This certifies that this application was completed by me and that all entries and the information herein are true and complete to the best of my knowledge.

Once you complete your application and are ready to submit it, please click "Send". You will not be able to make any further edits once you click send.

Traffic Convictions & Forfeitures for Past 3 Years

Employment History

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Driving/Hauling Experience With This Employer

Authorization