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DRIVER’S APPLICATION FOR EMPLOYMENT

George Hildebrandt, Inc.
412 Stone Mill Road, Hudson, New York 12534

 

 

In compliance with Federal and state 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.

 
First Name:
 
Middle Name:
 
Last Name:
 
Social Security #:
 
Phone #:
 
Position Applied For: Company Driver
Owner Operator
 Current Address
 
StreetCity
StateZip
How Long?
 Previous Address #1
 
StreetCity
StateZip
How Long?
 Previous Address #2
 
StreetCity
StateZip
How Long?
 Previous Address #3
 
StreetCity
StateZip
How Long?

Do you have a legal right to work in the United States?
  Yes  No 
  Date Of Birth:
  Can you provide proof of age?
Yes  No 
  Have you worked for this company before?

Yes  No   
Where?  

Dates: From:  To:  Rate of Pay:  Position: 
  Reasons For Leaving:

  Are you employed now? Yes  No 
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)?
  If yes, explain if you wish.




EMPLOYMENT HISTORY
All driver applicants that drive commercial motor vehicle in interstate or intrastate commerce must provide the following information on all employers during the preceding 10 years. List complete mailing address, street number, city, state and zip code. (Note: list employers in reverse order starting with the most recent. Add another sheet as necessary.

Employer #1 DATE
Name
Address
City  State  
Zip  
Contact Person
Phone Number
From To 
Position Held
Salary/Wage
Reason For Leaving
Employer #2 DATE
Name
Address
City  State  
Zip  
Contact Person
Phone Number
From To 
Position Held
Salary/Wage
Reason For Leaving
Employer #3 DATE
Name
Address
City  State  
Zip 
Contact Person
Phone Number
From To 
Position Held
Salary/Wage
Reason For Leaving
Employer #4 DATE
Name
Address
City  State  
Zip 
Contact Person
Phone Number
From To 
Position Held
Salary/Wage
Reason For Leaving
Employer #5 DATE
Name
Address
City  State  
Zip 
Contact Person
Phone Number
From To 
Position Held
Salary/Wage
Reason For Leaving
Employer #6 DATE
Name
Address
City  State  
Zip  
Contact Person
Phone Number
From To 
Position Held
Salary/Wage
Reason For Leaving
Accidents
DateNature of AccidentFatalitiesInjuries


Traffic Convictions And Forfeitures For Past 3 Years (Other Than Parking Violations) If None, Write None.
LocationDateChargePenalty


Education
Please select the highest grade that you've completed.
Grade School 1 2 3 4 5 6 7 8
High School 9 10 11 12
College 1 2 3 4
  Name of Last School Attended:
  Location of Last School:



Driver Experience And Qualifications
StateLicense #TypeExp Date
Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
Yes   No 
Has any license, permit or privilege ever been suspended or revoked?
Yes   No 


Driving Experience If None, Write None.
Dates
ClassTypeFromTo# of Miles Driven
Straight Truck
Tractor & Semi-Trailer
Tractor - Two Trailers
Motorcoach - School Bus
Other


  List States Operated In The Last Five Years:
  Show Special Courses or Training That Will Help You As a Driver:
  Which Safe Driving Awards Do You Hold and From Who?
 

EXPERIENCE AND QUALIFICATIONS OTHER

Show Any Trucking, Transportation, or Other Experiences 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 Shown)
 



Background Investigation Consent

In connection with, and for the duration of my employment (including testing and contract for services), I hereby authorize George Hildebrandt, Inc. and/or its agents to make an independent investigation of my background, references, character, past employment, education, driving history, criminal or police records, including those maintained by both public and private organizations, and all public records for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for employment.

Further, if hired by George Hildebrandt Inc., I understand and authorize that a periodic or updated background investigation may be requested for the duration of my employment (for any purpose including job retention, job promotion, changes in job title/ responsibilities, transfers, security clearance functions, etc.)

I release 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 reference sources used. The following is my true and complete legal name and all information is true and correct to the best of my knowledge.

Name: 
Date: