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 *

License ever 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? *

Failed a Drug/Alcohol Screening? *

If yes, when? *

Current Employer
Please type N/A or None if you are currently unemployed

Employer *

Start Date *

End Date *

Address *

City *

State *

Phone Number *

Job Duty *

Reason for Leaving *

Past Employer 1

Employer *

Start Date *

End Date *

City *

State *

Address *

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 *

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.

Type Full Name to eSign for Background Release *

I Give Permission to have TDC run my MVR *

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