APPLICATION

FOR DRIVERS

Driver's Application for Employment

Fill out form completely.  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, or non-job related disability.

 

In connection with application for safety qualification with this company, I fully understand a complete investigative report will be made. Such investigation will include information as to my character, work habits, complete driving record, performance, and experience. It will include information concerning any of my past controlled substance tests, along with reasons for termination from my previous positions. I authorize, with reservation, any party or agency contact to furnish the above-mentioned information and will not hold such parties liable in any way for providing such information to Rock River Cartage, Inc.

 

I further understand that I will, as a condition of qualification, be given an alcohol, drug, and controlled substance screening test. A positive test result will be considered in our final decision of your application. I agree that in the event of any related accident, I may undergo additional testing for controlled substances and alcohol, and I give my permission for such testing to be completed.

 

I HAVE READ THE ABOVE POLICY AND FULLY UNDERSTAND ITS MEANING. I AGREE TO COMPLY WITH IT AS PART OF MY INITIAL SCREENING

AND CONTINUOUS QUALIFICATION WITH ROCK RIVER CARTAGE, INC.

Driver Disclosure Form: PLEASE PRINT AND SIGN DOCUMENT

NOTE: All fields are required. If you come across a section that does not apply to you, please just enter N/A

Submitting Form...

The server encountered an error.

Form received.

List your complete addresses of residency for the past three years.

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding three years. Please list additional employers and information detailed below to be kept with application.

 

Applicants to drive a commercial motor vehicle in intrastate or interstate commerce shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle. (*Note: List employers in reverse order starting with the most recent. If more space is needed please inform us during the interview.

ACCIDENT RECORD

Accident record for past three years or more. If none then skip this area.  If answering yes, then please explain below.

TRAFFIC CONVICTIONS

Have you had any traffic violations job related?  If yes please tell us the LOCATION, DATE, CHARGE, and PENALTY of the violation.  If you need more please explain at time of interview.

EXPERIENCE & QUALIFICATIONS

Please list your Driver Licenses in the box below.  We will need the STATE, LIC. #, TYPE, EXPIRATION DATE

DRIVING EXPERIENCE

Please list your driving experience with each type of equipment, if you do not have any experience with that type please type "NONE". List type of equipment, dates and approx. number of total miles.

TO BE READ AND AGREED BY APPLICANT

 

Clicking on "SUBMIT" certifies that this application was completed by me (applicant), and that all entries on it and information in it are true and complete to the best of my knowledge. I understand that falsification of this information is grounds for refusal to hire or, if I’ve been hired, for termination.

 

I authorize Rock River Cartage to make such investigations and inquiries of my personal, employment, medical history, and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medial history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, and other persons from all liability in responding to inquiries and releasing truthful and lawful information they might have, personal or otherwise, with regard to any of the subjects covered by this application.

 

In consideration for my employment with your company, I agree to conform to the rules and regulations of the company as set forth in the company’s employee handbook and acknowledge that these rules and regulations may be changed interpreted, withdrawn, or be added to by the employer at any time, at the employer’s sold option and without any prior notice to me.

 

I further acknowledge that if I am employed by Rock River Cartage, my employment will be at will, and may be terminated with or without cause at any time by me or by the employer.

 

 

If you answered "YES", then please explain below.  Please list DATE of ACCIDENT, NATURE OF ACCIDENT, ANY FATALITIES, ANY INJURIES

NOTE: Your date of birth is required to run your (MVR) Motor Vehicle Record.

13475 Galt Rd.

Sterling, IL 61081

 

T: (815) 625-1699