Driver Application

Personal Information

In compliance with Federal and State equal opportunity laws, qualified applicants are considered for all positions without regards to race, color, religion, sex, national origin, age, marital status, or non-job related disability.

* REQUIRED FIELD





Please list your address of residency for the past 3 years:

Current Address


Previous Addresses








YesNo

General Information

* REQUIRED FIELD


YesNo








YesNo





YesNo




YesNo



Employment History

* REQUIRED FIELD

All driver applicants to drive in interstate commerce must provide the following information on all employers/leasors during the preceding 3 years. List a complete mailing address including phone number, street number, city, state, and zip code.

Applicants shall also provide an additional 7 years' information on previous employers/leasors.
A TOTAL OF 10 YEARS HISTORY IS REQUIRED.

NOTE: List employers in reverse order starting with the most recent.

Previous Employers







Accident Record & Traffic Convictions


Accident
(head-on, rear-end, upset, etc.)


Traffic convictions & forfeitures for the past 3 years (other than parking violations)


Traffic conviction or forfeiture


Education




Latest school attended

Driving Experience

* REQUIRED FIELD

Driver Licenses






Drug and alchol information











Straight truck



Tractor & semi-trailer



Tractor –two trailers



Motorcoach-school bus



Other




Other Experience and Qualifications




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

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment is intent.)

I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment with MN Express Inc, I understand that false or misleading information given in my application or interview (s) may result in termination/cancellation of lease. I understand also, that I am required to abide by all rules and regulations of the aforementioned company.