Driver's Application for Employment

APPLICANT TO COMPLETE
(All Questions marked with an * must be answered)

The Following is my true legal name and all of this information is true and correct to the best of my knowledge

List your addresses of residency for the past 3 years

Current Address

Previous Address(es) If At Current Address Less Than 3 Years

To download a copy of the job description for a commercial motor vehicle driver, click here.

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.)

You will be asked if your job designated as a safety sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40Includes 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.

You will be asked if you were subject to the FFCSRs while employed. The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport 9 or more passengers, OR (3) is of any size is used to transport hazardous materials in quantity requiring placarding.

Previous Employer

Previous Employer

Previous Employer

Previous Employer

Previous Employer

ACCIDENT RECORD FOR PAST 3 YEARS OR MORE

If you have not had an accident,type NA for the date. List the most recent accident first

Previous Accident

Previous Accident

Previous Accident

Traffic Convictions or Forfeitures For The Last 3 Years

Other than parking violations. If none, type none

Previous Conviction or Forfeiture

Previous Conviction or Forfeiture

Experience And Qualifications

List all drivers licenses held in the last 3 years.

Type(s) of Equipment Operated

Experience And Other Qualifications - Other

Education

Please Circle The Highest Grade Completed

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race color, religions, sex, national origin, age marital status, veteran status, non-job related disability, or any other protected group status.

DRUG FREE WORKPLACE


Southern Ag Carriers, Inc. Is a Drug Free workplace. All applicants are required to pass a pre-employment physical, drug screen and alcohol test. Southern Ag Carriers, Inc. has a zero tolerance. Anyone not passing required physical, alcohol and drug testing will not be hired. All employees are subject to random, post-accident and reasonable suspicion testing.

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make such investigations and inquiries of my personal, employment, criminal, financial or medical history history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquires 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, criminal or police records, 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 information I provide regarding 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 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; and
  • 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.

I release Southern AG Carriers, Inc. And/or its agents and any person or entity, which provides information pursuant to this authorization, from any and all liabilities, claims or lawsuits in regards to the information obtained from any and all of the above referenced sources used.

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.
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 Southern AG Carriers, Inc. as permitted by law.
I further understand that if hired I will be on 90 days probation.