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Step 1 of 5: Application

Please take your time to review this application before filling it out. Each question should be fully and accurately answered before going to the next step. There are five steps required to be filled out before any action can be taken on this application. The steps are: 1-Application, 2-Preview, 3-Prescreening Questions, 4-EEO, 5-Resume

*Note if you do not see a step 3, there are no job related prescreening questions.
* is required field.
GENERAL
PLEASE FILL IN ALL INFORMATION

Any employment resulting from this application will be employment at will. This means that you have the right to terminate employment at any time for any reason, and the Company may exercise the same right.
Email Address *
(If no Email, Enter 000@00.com)
Password
(at least 6 characters) *
Retype Password Again
(at least 6 characters) *
NAME (Last) *
(First) *
(Middle)  
PRESENT ADDRESS (Street) *
(City) *
(State) *
(Zip) *
How many years living at this address? If less than 3 years, please include additional addres(es) below:  
Home Telephone *
Work Telephone     
Former Address (Street)  
(City)  
(State)  
(Zip)  
How long at this address?  
Former Address (Street)  
(City)  
(State)  
(Zip)  
How long at this address?  
Former Address (Street)  
(City)  
(State)  
(Zip)  
How long at this address?  
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE U.S. ON AN UNRESTRICTED BASIS? *   
Yes No
ARE YOU AT LEAST 24 YEARS OF AGE?     
Yes No
Have you ever been convicted of a felony or misdemeanor? *   
Yes No
(Conviction will not necessarily disqualify an applicant for employment)
(You may answer “No” if your felony or misdemeanor conviction(s) has been annulled or expunged from court records or is contained in a sealed or juvenile record or you have been officially pardoned. For California applicants only, you may omit reference to any marijuana-related offenses if the date of the conviction is more than two years ago.)
If yes, please explain:     

POSITION APPLIED FOR     
SALARY / WAGE REQUESTED *
PER  
EARLIEST DATE AVAILABLE (mm/dd/yyyy)     Pick A Date Pick a date
CHECK WHAT TYPE OF WORK YOU ARE LOOKING FOR (check all that apply)
     
FULL-TIME WORK     PART-TIME WORK     OTR DRIVER     LOCAL DRIVER     
WHAT LED YOU TO APPLY FOR A POSITION WITH THIS COMPANY? *   
Please specify: *   
ARE YOU A FORMER EMPLOYEE OF THIS COMPANY OR ANY OF ITS SUBSIDIARIES OR AFFILIATES? *   
Yes No
EMPLOYMENT FROM: (mm/dd/yyyy)        Pick A Date Pick a date
TO: (mm/dd/yyyy)     Pick A Date Pick a date
JOB TITLE  
LOCATION  
PRIMARY REASON FOR LEAVING     

ARE YOU RELATED TO ANYONE IN OUR EMPLOY? *   
Yes     No     
IF YES, STATE EMPLOYEE NAME AND DEPARTMENT:  

EDUCATION
Please list all education, skills and training you feel may relate to the position(s) for which you have applied.
1. Education *
Name & Location of School *
Major Course or Subject *
# of Years Attended *
Did you Graduate? *
Yes No
Degree Received *
GPA  
2. Education  
Name & Location of School  
Major Course or Subject  
# of Years Attended  
Did you Graduate?  
Yes No
Degree Received  
GPA  
3. Education  
Name & Location of School  
Major Course or Subject  
# of Years Attended  
Did you Graduate?  
Yes No
Degree Received  
GPA  
4. Education  
Name & Location of School  
Major Course or Subject  
# of Years Attended  
Did you Graduate?  
Yes No
Degree Received  
GPA  
LIST PROFESSIONAL CERTIFICATIONS, LICENSES, SPECIALIZED TRAINING AND ANY OFFICES HELD     

LIST SKILLS OR EQUIPMENT OPERATING ABILITIES THAT YOU HAVE WHICH MIGHT BE USEFUL IN THE POSITION FOR WHICH YOU ARE APPLYING     


EMPLOYMENT RECORD
LIST ALL EMPLOYMENT FOR THE LAST TEN (10) YEARS WITH THE CURRENT / MOST RECENT POSITION FIRST. ACCOUNT FOR ANY PERIODS OF UNEMPLOYMENT. If you are a current CDL holder, please provide 10 years of employment history including any gaps.
Last or current Employer *
Phone No. *
Date Employed From: (mm/dd/yyyy) *   Pick A Date Pick a date
To: (mm/dd/yyyy) *   Pick A Date Pick a date
Address *
City *
State *
Zip *
Starting Hourly Rate / Salary *
Per *
Final Hourly Rate / Salary *
Per *
Other Compensation     
Job Title *
Immediate Supervisor *
Supervisor Title *
May we contact for a reference? *
Yes No
Summarize the nature of the work performed & job responsibilities: *   

Reason for Leaving: *   

Were you subject to the Federal Motor Carrier Safety Regulations while employed? *   
Yes No
Was 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 40? *   
Yes No
2. Employer  
Phone No.  
Date Employed From: (mm/dd/yyyy)     Pick A Date Pick a date
To: (mm/dd/yyyy)     Pick A Date Pick a date
Address  
City  
State  
Zip  
Starting Hourly Rate / Salary  
Per  
Final Hourly Rate / Salary  
Per  
Other Compensation     
Job Title  
Immediate Supervisor  
Supervisor Title  
May we contact for a reference?  
Yes No
Summarize the nature of the work performed & job responsibilities:     

Reason for Leaving:     

Were you subject to the Federal Motor Carrier Safety Regulations while employed?     
Yes No
Was 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 40?     
Yes No
3. Employer  
Phone No.  
Date Employed From: (mm/dd/yyyy)     Pick A Date Pick a date
To: (mm/dd/yyyy)     Pick A Date Pick a date
Address  
City  
State  
Zip  
Starting Hourly Rate / Salary  
Per  
Final Hourly Rate / Salary  
Per  
Other Compensation     
Job Title  
Immediate Supervisor  
Supervisor Title  
May we contact for a reference?  
Yes No
Summarize the nature of the work performed & job responsibilities:     

Reason for Leaving:     

Were you subject to the Federal Motor Carrier Safety Regulations while employed?     
Yes No
Was 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 40?     
Yes No
4. Employer  
Phone No.  
Date Employed From: (mm/dd/yyyy)     Pick A Date Pick a date
To: (mm/dd/yyyy)     Pick A Date Pick a date
Address  
City  
State  
Zip  
Starting Hourly Rate / Salary  
Per  
Final Hourly Rate / Salary  
Per  
Other Compensation     
Job Title  
Immediate Supervisor  
Supervisor Title  
May we contact for a reference?  
Yes No
Summarize the nature of the work performed & job responsibilities:     

Reason for Leaving:     

Were you subject to the Federal Motor Carrier Safety Regulations while employed?     
Yes No
Was 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 40?     
Yes No

PROFESSIONAL / BUSINESS REFERENCES WHO MAY BE CONTACTED
(List three. Do not include relatives.)
1. Name *
Relationship *
Address *
Phone Number *
How Long known *
2. Name *
Relationship *
Address *
Phone Number *
How Long known *
3. Name *
Relationship *
Address *
Phone Number *
How Long known *
Do you have a commercial driver's licence? *   
Yes No
If applying for a DOT regulated position (vehicle over 10,001 GVWR) you are required to complete the Driving Experience and Qualification Section. If not, please proceed to the final section of this application.

DRIVING EXPERIENCE AND QUALIFICATIONS
Driving Experience
Do you have any professional driving experience in the last three (3) years:     
Yes No
If yes, please select the appropriate Class of Equipment, Type of Equipment, Dates or Approximate Number of Miles.
Class of Equipment  
Type of Equipment     
Van     Reefer     Tank     Flat     
From        Pick A Date Pick a date
To        Pick A Date Pick a date
Approximate number of miles     
Class of Equipment  
Type of Equipment     
Van     Reefer     Tank     Flat     
From        Pick A Date Pick a date
To        Pick A Date Pick a date
Approximate number of miles     
Class of Equipment  
Type of Equipment     
Van     Reefer     Tank     Flat     
From        Pick A Date Pick a date
To        Pick A Date Pick a date
Approximate number of miles     
Class of Equipment  
Type of Equipment     
Van     Reefer     Tank     Flat     
From        Pick A Date Pick a date
To        Pick A Date Pick a date
Approximate number of miles     
Class of Equipment  
Type of Equipment     
Van     Reefer     Tank     Flat     
From        Pick A Date Pick a date
To        Pick A Date Pick a date
Approximate number of miles     
Class of Equipment  
Type of Equipment     
Van     Reefer     Tank     Flat     
From        Pick A Date Pick a date
To        Pick A Date Pick a date
Approximate number of miles     
Class of Equipment
(If other, please specify here.)  
Type of Equipment     
Van     Reefer     Tank     Flat     
From        Pick A Date Pick a date
To        Pick A Date Pick a date
Approximate number of miles     
Accident History (3 years)
Have you had any accidents in the last three years?     
Yes No
Nature of Accident:
(head-on, rear-end, upset, etc.)     
Date        Pick A Date Pick a date
Number of fatalities     
Number of injuries     
Hazardous materials spill?     
Yes No
Nature of Accident:
(head-on, rear-end, upset, etc.)     
Date        Pick A Date Pick a date
Number of fatalities     
Number of injuries     
Hazardous materials spill?     
Yes No
Nature of Accident:
(head-on, rear-end, upset, etc.)     
Date        Pick A Date Pick a date
Number of fatalities     
Number of injuries     
Hazardous materials spill?     
Yes No
Traffic Convictions and Forfeitures (5 years)
Have you had any traffic convictions or license suspensions in the last 5 years?     
Yes No
Violation:
(Other than violations involving parking only)  
Date convicted     Pick A Date Pick a date
State of violation  
Penalty
(Forfeited bond, collateral and/or points)  
Violation:
(Other than violations involving parking only)  
Date convicted     Pick A Date Pick a date
State of violation  
Penalty
(Forfeited bond, collateral and/or points)  
Violation:
(Other than violations involving parking only)  
Date convicted     Pick A Date Pick a date
State of violation  
Penalty
(Forfeited bond, collateral and/or points)  
License Information

Section 383.21 Federal Motor Carrier Safety Regulation states “No person who operates a commercial motor vehicle shall at any time have more than one driver’s license”. I certify that I do not have more than one motor vehicle license, the information for which is listed below.
Birth Date: (mm/dd/yyyy)     Pick A Date Pick a date
SOCIAL SECURITY NUMBER  
Driver's License State     
Driver's License Number     
Driver's License Expiration Date        Pick A Date Pick a date
A. Have you ever been denied a license, permit, or privilege to operate a motor vehicle? *   
Yes No
If yes, give details:     

B. Has any license, permit, or driving privilege ever been suspended or revoked? *   
Yes No
If yes, give details:     


CERTIFICATION AND ACKNOWLEDGEMENT STATEMENT
I hereby authorize AmeriFleet Transportation and/or its representatives permission to gather background information regarding the following: Information from previous employers, whether contained in written records or not; all public/private records, including criminal, civil, driving, credit, education or medical history; and any other pertinent information relating to the successful function of the job for which I am considered. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) Finally, I hereby release AmeriFleet Transportation, its authorized agents, former employees, employers, schools, health care providers and other references from all liability in responding to inquiries and releasing information in connection with my application.

I also understand that any employment offer is contingent upon my providing, within three (3) days of employment, valid proof of identity and eligibility to work in compliance with the Immigration Reform and Control Act of 1986, as amended.

All applicants for employment will be considered without regard to race, religion, color, national origin, sex, pregnancy status, marriage status, age, disability/handicap, veteran status, or sexual orientation.

I acknowledge that if I am employed, such employment is not for a definite period of time, and that AmeriFleet Transportation can change wages, benefits, hours of employment, and conditions at any time without notice. I understand that either, I or AmeriFleet Transportation can terminate the employment relationship at any time, with or without prior notice, for any reason not prohibited by law. In the event that I leave AmeriFleet Transportation I will promptly pay any balance owed for merchandise, equipment or uniforms issued to me and damaged or not returned, or other indebtedness to AmeriFleet Transportation. Finally, I authorize AmeriFleet Transportation to apply any money due to me for wages, salary, and commissions toward liquidation of this indebtedness, except where prohibited by law.

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. By signing here, I agree that I have read and understand that any material misrepresentation or omission of material fact in this Application for Employment may be justification for refusal of, or if employed, termination of employment, regardless of when such falsification is discovered.

If applying for a Department of Transportation regulated position, the following statement also applies:

Department of Transportation: "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 current/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."
The application acknowledges that any offer of employment that is made by AmeriFleet Transportation may be contingent upon my successful completion of a physical examination that conforms to the requirements and specifications of the Americans with Disabilities Act and/or the successful completion of a drug test that conforms to state and federal laws.
I AUTHORIZE VERIFICATION OF
     
All information given     All information except present employer     
NAME: *
DATE *      Pick A Date Pick a date

About SSL Certificates
 
© 2005, All rights reserved.   |   1360 Union Hill Road, Building Two, Alpharetta, GA 30004   |   PH: (800) 728-9235  |   Fax: (800) 309-0464  | info@amerifleet.com