Enter previous employers. CDL should include employment history required for DOT review.
These can be completed later by Safety if the applicant does not know them.
Documents are optional at this step. Upload them now if available, or Safety can upload missing documents later from the review screen.
Allowed files: PDF, JPG, PNG. Max 8 MB each.
To Be Read and Signed by Applicant / Application Authorization
I authorize you to make investigations and inquiries of my personal, employment, financial,
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.
I understand that the information I provide regarding my 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 49 CFR 391.23(d) and (e). I understand that I have the right to:
- Review information provided by current/previous employers.
- Have errors in the information corrected by previous employers, and for those previous employers to re-send the corrected information to the prospective employer.
- Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
- As part of background information that you provide on this application, you are not required to provide, and you shall not voluntarily provide the company, with any information regarding any conviction/arrest record pertaining to you that have been sealed or expunged at a court of law.
- 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.
Required signature. Sign inside the box with your finger or mouse.