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Hughson
Trucking Inc.

Hughson Trucking Inc.
P.O. Box 149
Milk River, AB
T0K IM0
(403)647-2763 FAX (403)647-2763

 

DRIVER’S APPLICATION FOR EMPLOYMENT

In compliance with Federal and Provincial 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.





Name

Last First Middle

Email Address: Please leave the pre-filled default if you do not have an email address

List your address of residency for the past three years

Current Address

Street City State/Province

Phone How long?

PostalCode

Do you have the legal right to work in the United States?

Date of Birth / / Can you provide proof of age?

D M Y

Have you worked for this company before? Where?

Dates: From to Rate of Pay Position

Reason for leaving

Are you now employed? If not, how long since leaving last employment?

Who referred you? Rate of pay expected

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 No

If yes, explain if you wish

Employment History

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding three years. List complete mailing address, street number, city, state/province, and postal code.

Applications to drive a commercial motor vehicle in intrastate or interstate commerce shall also provide and additional seven 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 necesary).

EMPLOYER
DATE
NAME
FROM MO YR TO MO YR
ADDRESS
POSITION HELD

CITY STATE/PROVINCE POSTALCODE

REASON FOR LEAVING

CONTACT.PERSON PHONE.NUMBER

EMPLOYER
DATE
NAME
FROM MOYR TO MO YR
ADDRESS
POSITION HELD

CITY STATE/PROVINCE POSTALCODE

REASON FOR LEAVING

CONTACT.PERSON PHONE.NUMBER

EMPLOYER
DATE
NAME
FROM MOYR TO MO YR
ADDRESS
POSITION HELD

CITY STATE/PROVINCE POSTALCODE

REASON FOR LEAVING

CONTACT.PERSON PHONE.NUMBER

Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle to transport hazardous materials in a quantity requiring placarding.

ACCIDENT RECORD FOR PAST 3 YEARS OR MORE (IF NONE, WRITE NONE)

DATES
NATURE OF ACCIDENT (HEAD-ON, REAR-END, UPSET, ETC.)
FATALITIES
INJURIES

LAST ACCIDENT

NEXT PREVIOUS

NEXT PREVIOUS

TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS

(OTHER THAN PARKING VIOLATIONS) IF NONE, WRITE NONE

LOCATION
DATE
CHARGE
PENALTY

EXPERIENCE AND QUALIFICATIONS – Driver

Driver’s License
STATE/PROVINCE
LICENSE
TYPE
EXPIRATION DATE

*Must posses one license only

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

 Yes No

B. Has any license, permit or privilege even been suspended or revoked?

 Yes No

* IF THE ANSWER TO EITHER A OR B IS YES, EXPLAIN:

DRIVING EXPERIENCE(IF NONE, WRITE NONE)

CLASS OF EQUIPMENT
TYPE OF EQUIPMENT(VAN, TANK, FLAT, ETC.)
DATES
FROM
TO
STRAIGHT TRUCK
TRACTOR AND SEMI-TRAILER
TRACTOR – TWO TRAILERS

EXPERIENCE AND QUALIFICATION

Show any trucking, transportation or other experience that may help in your work for this company

Using Dashes , Please List courses and training ( eg course1 – course 2 -course 3)

TO BE READ AND SIGNED BY APPLICANT

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.

Date

Applicant’s Signature

Submit a file/attachment or picure


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