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Employment Opportunities
Name:_________________________________________________________ Phone ( )____________________ S.S.N.#__________________________ Present Address__________________________________________________ City__________________________ State_________ Zip_________________ Height_____________________Weight________ Date of Birth_____________ How Many Years of Tactor/Trailer Experience Do You Have?_______________ Present or Last Employer City__________________________ State_________ Zip_________________ Phone ( )_____________________ Position __________________________ From:_________________________ To:______________________________ Equipment Operated: Van____________________ Tank:__________________ Second Last Employer City__________________________ State_________ Zip_________________ Phone ( )_____________________ Position __________________________ From:_________________________ To:______________________________ Equipment Operated: Van____________________ Tank:__________________ Third Last Employer City__________________________ State_________ Zip_________________ Phone ( )_____________________ Position __________________________ From:_________________________ To:______________________________ Equipment Operated: Van____________________ Tank:__________________ Current Drivers License CDL: Yes____ No_____ Endorsements_____________________________ Moving Violations (Last 3 Years)__________ Accidents (Last 3 Years)________ Has License ever been suspended/revoked?________ When?________________ Have you ever had a DUI/DWI?__________ When?______________________ Do you have a felony conviction?__________ When? ______________________ I certify that all information on this form is correct and complete to the best of my knowledge. I authorize SUTTLES TRUCK LEASING, LLC., to perform a complete background investigation in accordance with state and federal laws. I authorize any former employer to release any information required on this form, including alcohol and controlled substance test information to SUTTLES TRUCK LEASING, LLC. I hereby release all former employers from any liability or damages. Signature_______________________________________ Date____________________
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