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APPLICATION FOR EMPLOYMENT
DRIVER’S APPLICATION FOR EMPLOYMENT
Aviles Transport LLC.
3111 Cottonwood Ct, CA
Buss. (805)871-9220
GENERAL INFORMATION
Position(s) Applied for
COMMERCIAL TRUCK DRIVER
Date of Application
MM slash DD slash YYYY
Name
First
Last
Social Security Number
Date of Birth
MM slash DD slash YYYY
Commercial Driver License Number
DateCDL Expiration Date
MM slash DD slash YYYY
List your addresses of residency for the past 3 years (Current Address First)
Street
City
State
Zip code
Phone Number
Home Phone Number
Emergency Contact Number
Previous Address
Previous Address 1 - Street
City
State
Zip code
Previous Address 2 - Street
City
State
Zip code
Previous Address 3 - Street
City
State
Zip code
Information Required
Do you have a legal right to work in the United States?
Have you worked for Aviles Transport LLC. before? Where?
Reason for leaving?
Are you now employed? If not how Long since last employment?
Who referred you?
Rate of pay expected?
Is there are any reason you might be unable to perform the functions of the job for which you have applied (as described in the attached job description? If yes, explain if you wish.
EDUCATION
Name of Last School Attended:
Circle Highest Grade Completed
1
2
3
4
5
6
7
8
City:
High School
9
10
11
12
State:
College:
1
2
3
4
EXPERIENCE AND QUALIFICATIONS AS A DRIVER
Driver Licenses
State
License No.
Type
Exp. Date
MM slash DD slash YYYY
State
License No.
Type
Exp. Date
MM slash DD slash YYYY
A. Have you ever been denied a license, permit or privilege to operate a motor
Yes
No
B. Has any license, permit or privilege ever been suspended or revoke?
Yes
No
If the answer to either A or B is Yes, attach statement giving details
EMPLOYMENT HISTORY
EMPLOYMENT HISTORY All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state, and zip code. 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 add another sheet as necessary.)
Employer
Company Name
Date of Employment: From
MM slash DD slash YYYY
Date of Employment: To
MM slash DD slash YYYY
Street
City
State
Zip Code
Salary
Position
Contact Person
Phone Number
Reason for leaving
Employer
Company Name
Date of Employment: From
MM slash DD slash YYYY
Date of Employment: To
MM slash DD slash YYYY
Street
City
State
Zip Code
Salary
Position
Contact Person
Phone Number
Reason for leaving
Employer
Company Name
Date of Employment: From
MM slash DD slash YYYY
Date of Employment: To
MM slash DD slash YYYY
Street
City
State
Zip code
Salary
Position
Contact Person
Phone Number
Reason for leaving
Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.
DRIVING RECORD
Accident record for past 3 years or more (attach sheet if more space is needed) if none, write none
Last Accident
MM slash DD slash YYYY
Nature of Accident (Head-on rearend, upset, Etc.)
Fatalities
Injuries
Next Previous
MM slash DD slash YYYY
Nature of Accident (Head-on rearend, upset, Etc.)
Fatalities
Injuries
Next Previous
MM slash DD slash YYYY
Nature of Accident (Head-on rearend, upset, Etc.)
Fatalities
Injuries
Traffic convictions and forfeitures for the past 3 years (other than parking violations) if none, write none.
Location
Date
MM slash DD slash YYYY
Charge
Penalty
Location
Date
MM slash DD slash YYYY
Charge
Penalty
Location
Date
MM slash DD slash YYYY
Charge
Penalty
DRIVING EXPERIENCE AND QUALIFICATIONS (if none, write none)
Straight Truck
Type of Equipment (Van, Tank, Flat, Etc.)
Approx. No of Miles (Total)
From Date
MM slash DD slash YYYY
Approx. No of Miles (Total)
MM slash DD slash YYYY
Tractor – 2 Trailers
Type of Equipment (Van, Tank, Flat, Etc.)
Approx. No of Miles (Total)
From Date
MM slash DD slash YYYY
Approx. No of Miles (Total)
MM slash DD slash YYYY
Tractor and Semi-Trailer
Type of Equipment (Van, Tank, Flat, Etc.)
Approx. No of Miles (Total)
From Date
MM slash DD slash YYYY
Approx. No of Miles (Total)
MM slash DD slash YYYY
Other
Type of Equipment (Van, Tank, Flat, Etc.)
Approx. No of Miles (Total)
From Date
MM slash DD slash YYYY
Approx. No of Miles (Total)
MM slash DD slash YYYY
List States operated in for last five years:
Show special courses or training that will help you as a driver:
Which safe driving awards do you hold and from whom?
Show any trucking, transportation or other experience that may help in your work for our company?
List courses and training other than shown elsewhere in this application
List special equipment or technical materials you can work with (other than those already shown)
PROCESS RECORD
TO BE READ AND SIGNED BY APPLICANT
This certifies that I completed this application, and that all entries on it and information in it are true and completed 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 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 the company.
Date
MM slash DD slash YYYY
Applicant’s Signature
Applicant Hired
Rejected
Date Employed
MM slash DD slash YYYY
Point Employed
Department
(If rejected, summary report of reasons should be placed in file)
Classification
This section to be filled in by responsible officer or company representative.
Application
Superior
Good
Fair
Below Average
Poor
Written Record on File
Interview
Superior
Good
Fair
Below Average
Poor
Written Record on File
Past Employment
Superior
Good
Fair
Below Average
Poor
Written Record on File
Written Exam
Superior
Good
Fair
Below Average
Poor
Written Record on File
Road Test
Superior
Good
Fair
Below Average
Poor
Written Record on File
Criminal and Traffic Convictions
Superior
Good
Fair
Below Average
Poor
Written Record on File
Signature of Interviewing Officer
TERMINATION OF EMPLOYMENT
Terminated
MM slash DD slash YYYY
Position Release From
MM slash DD slash YYYY
Dismissed
MM slash DD slash YYYY
Voluntary Quit
MM slash DD slash YYYY
Other
Termination Report Placed in File
Supervisor
Office Use Only:
Emergency Contact Sheet
Please complete the following information on this sheet and turn in to your Human Resources Manager.
This information is imperative as it relates to the person we need to contact in case of an emergency. All information is kept confidential.
Thank you for your cooperation.
Name
First
Last
Position
Person to contact in case of emergency
First
Last
Relationship
Phone Number 1
Phone Number 2
Address
Person to contact in case of emergency 2
First
Last
Relationship
Phone Number 1
Phone Number 2
Address
Special Instructions for contacting your next of kin.
Employee Signature (Required)
Date
MM slash DD slash YYYY
Email Address
