Driver Application | CJKLogistics

Phone Number*

Email Address*

City*

State*

Zip Code*

Date of Birth*

Social Security Number*

City*

State*

Zip Code*

Number of Years Lived *

State*

License Number*

Type*

Class*

Expiration Date*

State

License Number

Type

Class*

Expiration Date

Straight Truck

Type of Equipment

Dates From

Dates To

Number of Miles

Tractor & Semi-Trailer

Type of Equipment

Dates From

Dates To

Number of Miles

Tractor & Two Trailers

Type of Equipment

Dates From

Dates To

Number of Miles

Other

Type of Equipment

Dates From

Dates To

Number of Miles

Date

Nature of Incident

Fatalities

Injuries

Date

Nature of Incident

Fatalities

Injuries

Date

Nature of Incident

Fatalities

Injuries

Date Convicted

State of Violation

Charge/Violation

Penalty

Date Convicted

State of Violation

Charge/Violation

Penalty

Date Convicted

State of Violation

Charge/Violation

Penalty

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

Street Address

City

State

From

To

Position Held

Salary

Gap in Employment (If Any, Include Dates and Reason)

Reason for Leaving

Were you subject to FMCSRs at this job?

Yes

No

Was this a DOT safety-sensitive position requiring drug & alcohol testing?

Yes

No

Street Address

City

State

From

To

Position Held

Salary

Gap in Employment (If Any, Include Dates and Reason)

Reason for Leaving

Were you subject to FMCSRs at this job?

Yes

No

Was this a DOT safety-sensitive position requiring drug & alcohol testing?

Yes

No

Street Address

City

State

From

To

Position Held

Salary

Gap in Employment (If Any, Include Dates and Reason)

Reason for Leaving

Were you subject to FMCSRs at this job?

Yes

No

Was this a DOT safety-sensitive position requiring drug & alcohol testing?

Yes

No

Applicant’s Signature*

Date*

Driver Application Form

APPLICANT INFORMATION

PREVIOUS THREE YEARS RESIDENCY

DRIVER'S LICENSE INFORMATION

DRIVING EXPERIENCE

ACCIDENT RECORD FOR PAST THREE YEARS

TRAFFIC CONVICTIONS & FORFEITURES FOR PAST THREE YEARS

EMPLOYMENT RECORD

Last Employer

Second Last Employer

Third Last Employer

TO BE READ AND SIGNED BY APPLICANT

Customer Testimonials