Applicants are considered without regard to race, creed, color, sex, religion, age, national origin or disability.
Personal information
Drivers License Record
Traffic convictions/forfeitures : Driving citations received for the past five (5) years, moving and non-moving
Accident report : List all vehicle accidents/incidents for the past five (5) years
Additional traffic violation history
(If YES to any give brief details & dates)
Explanation for general or other discharge
Employment history: A minimum of the previous three (3) years
Current or most recent employer
Dates of employment:month/year
2nd Most recent employer
Dates of employment:month/year
3rd Most recent employer
Dates of employment:month/year
4th Most recent employer
Dates of employment:month/year
By submitting this application, I certify that all the information on this form is correct and complete to the best of my knowledge. I understand that the information in this application will be used and that prior employers will be contacted for purposes of investigation required by 391.23 of the Federal Motor Carrier Safety regulations. I hereby authorize the release of any information on this application and I release said persons, previous employers and Careers World Wide, Inc. from any liability or damages.