Driver Application - Cardella Waste

"*" indicates required fields

Step 1 of 11

Personal Information

Name*

First Middle Last

Phone Number*

Email Address*

Date of Birth*

MM slash DD slash YYYY

Current Address

Street Address Address Line 2 City State ZIP Code

Time at current address

Previous Residence 1

Address

Street Address Address Line 2 City State ZIP Code

Time at this address

Previous Residence 2

Address

Street Address Address Line 2 City State ZIP Code

Time at this address

Are you legally permitted to work in the United States?*

Yes

Employment History

Were you previously employed by Cardella Trucking Co., Inc?*

Yes

Previously employed by Cardella from

MM slash DD slash YYYY

Previously employed by Cardella until

MM slash DD slash YYYY

Previous Position

Previous Rate of Pay

Reason for Leaving

Are you currently employed?*

Yes

Previously employed from

MM slash DD slash YYYY

Previously employed until

MM slash DD slash YYYY

Previous/Current Employer

All applicants must provide ten (10) years information on those employers for whom the applicant operated commercial motor vehicles (i.e., vehicles having a GVWR of 26,001 lbs or more, vehicles designated to transport fifteen (15) or more passengers, or any size vehicle used to transport hazardous materials in quantity requiring placarding).

Employer Name

Do you currently work here?

I am currently employed here

Employer Address

Street Address Address Line 2 City State ZIP Code

Contact Person

First Last

Did you drive a vehicle requiring a CDL?

Yes

Date you started working here

MM slash DD slash YYYY

Date you stopped working here

MM slash DD slash YYYY

Position Held

Salary Wage

Reason for leaving

Previous Employer 2

Employer Name

Employer Address

Street Address Address Line 2 City State ZIP Code

Contact Person

First Last

Did you drive a vehicle requiring a CDL?

Yes

Date you started working here

MM slash DD slash YYYY

Date you stopped working here

MM slash DD slash YYYY

Position Held

Salary Wage

Reason for leaving

Previous Employer 3

Employer Name

Employer Address

Street Address Address Line 2 City State ZIP Code

Contact Person

First Last

Did you drive a vehicle requiring a CDL?

Yes

Date you started working here

MM slash DD slash YYYY

Date you stopped working here

MM slash DD slash YYYY

Position Held

Salary Wage

Reason for leaving

Referrals

Name

Phone

Expected rate of pay

Criminal Background

Have you ever been convicted of a felony?*

Yes

Please explain fully

Conviction of a crime is not an automatic bar to employment. All circumstances will be considered.

Other

Is there 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?*

Yes

Please explain

Driving Record

Motor Vehicle Accidents Record

I have not been involved in any motor vehicle accidents in the past three (3) years.

Please list details about motor vehicle accident(s) you've been involved in

Date

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

Fatalities

Injuries

You can use the +/- buttons above to add more entries.

Traffic Convictions and Forfeitures

I have not been involved with any traffic convictions and/or forfeitures for the past three (3) years (other than parking violations).

Please list details about the convictions and/or forfeitures

Location

Date

Charge

Penalty

You can use the +/- buttons above to add more entries.

Experience and Qualifications - Driver

Driver Licenses

State

Last 4 Digits of License Number

Type

Expiration Date

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?*

Yes

Explain Why

Has any license, permit, or privilege ever been suspended or revoked?*

Yes

Explain Why

Education History

Choose the highest grade you completed:*

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

Attended college but did not complete

College 2-year degree

College 4-year degree

Name of last school attended:*

City of last school attended:*

I have experience driving:

Straight Truck

Tractor and Semi-Trailer

Tractor with Two Trailers

Motorcoach/School Bus

Other

Straight Truck Experience

Type of Equipment (Van, Tank, Flat, etc.)

Dates (from - to)

Approx. No. of Miles (total)

Tractor and Semi-Trailer Experience

Type of Equipment (Van, Tank, Flat, etc.)

Dates (from - to)

Approx. No. of Miles (total)

Tractor with Two Trailers Experience

Type of Equipment (Van, Tank, Flat, etc.)

Dates (from - to)

Approx. No. of Miles (total)

Motorcoach/School Bus Experience

Type of Equipment (Van, Tank, Flat, etc.)

Dates (from - to)

Approx. No. of Miles (total)

Other Experience

Type of Equipment (Van, Tank, Flat, etc.)

Dates (from - to)

Approx. No. of Miles (total)

Choose the states in which you operated a motor vehicle in for the last five (5) years:

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

District of Columbia

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

Armed Forces Americas

Armed Forces Europe

Armed Forces Pacific

Describe any special courses or training that help you as a driver:

What safe driving awards do you hold and from whom?

Experience and Qualifications - Other

Describe any trucking transportation or other experience that may help in your work for this 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 described)

To be Read and Signed by Applicant

Please put a check next to each statement if you agree.

Question 1*

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

Question 2*

I authorize you to make such investigation 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).

Question 3*

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.

Question 4*

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.

Signature*

Please type out your entire name. This serves as your signature.

Phone

This field is for validation purposes and should be left unchanged.