In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
TO BE READ AND SIGNED BY THE APPLICANT
I understand that the information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49CFT 391.23(d) and (e). I understand that I have the right to:
*The Federal Motor Carrier Safety Regulations appy to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: 1) weighs or has a GVWR of 10,001 pounds or more, 2) is designated or used to transport 9 or more passengers, or 3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.
**Any gaps in employment and/or employment must be explained.
List any additional license/s held in the past three (3) years:
Please list all motor vehicle accidents in which you were involved (commercial and private vehicle) during the three (3) years prior to the application date. If none, write “NONE”. Attach an additional document at the end of the application if necessary.
Please list all traffic convictions and/or forfeitures (commercial and private vehicle) during the three (3) years prior to the application date (other than parking). If none, write “NONE”. Attach an additional document at the end of the application if necessary.
I authorize you to make such investigations and inquire of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquires regarding medical history will be made only if, and after, a conditional offer of employment has been extended). 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, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of Astral Carrier, Inc. as well as the Federal Motor Carrier Safety Regulations. I also agree and understand that if I am selected to drive for Astral Carrier that I will be on a probationary period during which time I may be discharged without recourse.
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.