Online Application

* Indicates required field

Name *

First

Last

Phone Number *

Email *

City *

State *

Zip Code *

Social Security Number *

Date of Birth *

Where did you hear about TDC? *

CDL Information

License Number *

CDL Issue State *

Expiration Date *

Has your license been suspended or revoked? *

If yes, when and why? *

Any accidents in last 5 years? *

If yes, when and explain? *

Moving violations last 5 years? *

If yes, when and explain? *

Have DUI or DWI? *

If yes, when? *

Felony Convictions? *

If yes, when and explain? *

Employer *

Current Employer

Start Date *

End Date *

Address *

City *

State *

Phone Number *

Job Duty *

Reason for Leaving *

Past Employer 1

Employer *

Start Date *

End Date *

Address *

City *

State *

Phone Number *

Job Duty *

Reason for Leaving *

Past Employer 2

Employer *

Start Date *

End Date *

Address *

City *

State *

Phone Number *

Job Duties *

Reason for Leaving *

Past Employer 3

Employer *

Start Date *

End Date *

Address *

City *

State *

Phone Number *

Job Duties *

Reason for Leaving *

Type Full Name to eSign for Background Release *

By my electronic submission of this application for employment, I understand and agree that the company will investigate my background. This investigation includes DOT regulated and non-regulated employers as well as consumer reports (Hire Right, DAC, PSP, MVR, Criminal Background)

I give my consent for the company to obtain these reports and release my previous employers from all liability for damages for furnishing this information.

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