Driver Application

Please contact the Recruiting Department if you have any questions about this form or would like to talk to someone for more information.

Email Address:
First Name:
Middle Name:
Last Name:
Address:
City:
Zip:
Phone:
Social Security Number:
 
 
Class "A" CDL License?: Yes       No
Driver's License Number:
 
 
Are you a driving school graduate?: Yes       No
Name of Driving School:
 
 
Explain:
Explain:
 
 
Where did you hear about us? Newspaper       Driver       Other
Name of newspaper or driver:
 
 
Do you have any Felony Convictions? Yes      No
(Answering "Yes" does NOT disqualify your application.)
Have you ever refused to test for drugs or alcohol? Yes      No
Have you ever tested positive for drugs or alcohol? Yes      No
In the last 10 years have you had a DUI? Yes      No
In the last 10 years have you had a DWI? Yes      No
 
 
Do you have 2 years of OTR tractor-trailer driving experience during the last 3 years? Yes      No
Please List Employers & Unemployment Time For The Past 3 Years
Are you currently employed? Yes      No
May we contact present employer? Yes      No
 
Present or Most Recent Employer:
Address:
City:
 
Zip:
Telephone:
Type of Trailer: (check all that apply)
Number of States Ran:
Reason for Leaving:
 
 
Next Previous Employer:
Address:
City:
 
Zip:
Telephone:
Type of Trailer: (check all that apply)
Number of States Ran:
Reason for Leaving:
 
 
 
Next Previous Employer:
Address:
City:
 
Zip:
Telephone:
Type of Trailer: (check all that apply)
Number of States Ran:
Reason for Leaving:
 
 
Next Previous Employer:
Address:
City:
 
Zip:
Telephone:
Type of Trailer: (check all that apply)
Number of States Ran:
Reason for Leaving:
 
 
Certification
By submitting this form I certify that I personally completed this application and that all information is true and correct. I authorize TRANSPORT DISTRIBUTION COMPANY to do a complete background investigation in accordance with state and federal laws. I authorize my previous employers to release any information requested by TRANSPORT DISTRIBUTION COMPANY and hold them harmless of all liability from the release of said information. I authorize release of any information, including all information related to my alcohol and controlled substances testing and training records, by any former employers and hold them harmless of any liability from release of said information.
   
NOTE: You will automatically be redirected to our home page after submitting this form.

 





 




P.O. Box 306 • Joplin, Missouri 64802 • 800.866.7709 • Fax: 1.417.624.9767
Customer Line: (417) 624-3814

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