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

DRIVER NAME

IN CASE OF EMERGENCY-CONTACT

PREVIOUS ADDRESSES FOR THE PAST THREE (3} YEARS

COMMERCIAL DRIVER'S LICENSE INFORMATION:

Work Experience

IN ACCORDANCE WITH PART 391.21 & 23 OF THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS, AN APPLICANT MUST LIST ALL PREVIOUS WORK EXPERIENCE FOR THE LAST 3 YEARS PRIOR TO THE DATE OF THE APPLICATION, AS WELL AS ALL COMMERCIAL DRIVING EXPERIENCE FOR THE LAST 7 YEARS PRIOR TO THE DATE OF THE APPLICATION. 

PLEASE LIST EMPLOYMENT STARTING WITH THE MOST RECENT EMPLOYER

ADDRESS

ADDRESS

ADDRESS

COLLISIONS

PLEASE LIST ALL MOTOR VEHICLE COLLISIONS IN WHICH YOU WERE INVOLVED (BOTH COMMERCIAL AND PRIVATE VEHICLE) DURING THE PAST 3 YEARS PRIOR TO THE DATE OF THE APPLICATION. IF NONE, WRITE "NONE". 

TRAFFIC CONVICTIONS & FORFEITURES

PLEASE LIST ALL TRAFFIC CONVICTIONS AND/OR FORFEITURES (BOTH COMMERCIAL AND PRIVATE VEHICLE) FOR THE PAST 3 YEARS (OTHER THAN PARKING). IF NONE, WRITE "NONE". 

DRIVING EXPERIENCE

EQUIPMENT CLASS

EDUCATION

GENERAL

I HEREBY CERTIFY, BY MY SIGNATURE BELOW, THAT ALL OF THE INFORMATION ON THIS APPLICATION WAS COMPLETED BY MY HAND, AND THAT ALL ENTRIES ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE QUALITY DRIVERS TO MAKE INQUIRIES AND INVESTIGATIONS OF MY PERSONAL, EMPLOYMENT, DRIVING, FINANCIAL, AND/OR MEDICAL HISTORY AND OTHER RELATED MATTERS NECESSARY TO MAKE AN EMPLOYMENT DECISION.

IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN ON MY APPLICATION OR INTERVIEW(S) MAY RESULT IN DISCHARGE. I AGREE TO ABIDE BY THE RULES AND REGULATIONS OF QUALITY DRIVERS LOGISTICS AS WELL AS THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS. I ALSO AGREE AND UNDERSTAND THAT IF I AM SELECTED FOR EMPLOYMENT BY QUALITY DRIVERS LOGISTICS THAT I WILL BE ON A PROBATION PERIOD OF 90 DAYS DURING WHICH TIME I MAY BE DISCHARGED WITHOUT RECOURSE.