Apply for CLASS A TRUCK DRIVERS $5000 Sign On Delivery Frozen Buns

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Summary
Title:CLASS A TRUCK DRIVERS $5000 Sign On Delivery Frozen Buns
ID:1061
Department:Operations
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Home Phone:
Cell Phone:
Business Phone:
* Email:
Attachments
Resume:
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Cover Letter:
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Driver Application
APPLICANT NOTE
We offer equal employment opportunity to all based upon individual merit and without regard to age, sex, race, color, religion, national origin, sexual orientation, disability, marital, or veteran status. Give complete answers and print clearly.

Please advise us in advance if you need any type of special accommodation to complete this application form or to take a pre-employment test.

Please type or print in black ink. If any question does not apply to you, answer no or not applicable.

PERSONAL INFORMATION
* Social Security Number:
* Date of Birth:
* Driver's License Number:
* State Licensed:

RESIDENTIAL ADDRESS HISTORY (PAST THREE YEARS)

Street Address City or Town State Zip Code

* Date Available to Work:
* Have you ever been convicted of a crime, other than a minor traffic violation?
Yes   No
Provide the details of the conviction:
* Have you ever applied to The New Bakery Company of Ohio, Inc.?
Yes   No
If yes, give date and location:
* Have you ever worked for The New Bakery Company of Ohio, Inc.?
Yes   No
If yes, give the date, location, and type of work:
* Do you have relatives in our employ?
Yes   No
If yes, give names(s), relationship(s), and terminal locations(s):
* Have you ever been fired or asked to resign by an employer?
Yes   No
If yes, please explain:
* Is there any legal reason why you cannot be employed in this country?
Yes   No
If yes, please explain:
* 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
* Name of person to be notified in case of emergency

EMPLOYMENT HISTORY
In accordance with Federal Motor Carrier Safety Regulation 383.35c, list all employment during the past ten years in reverse order, starting with present or most recent employer. Include part-time, temporary, and military service.

If unemployed for a period of time, list the dates accordingly.

EMPLOYER 1

Dates Employed Employer Name & Address Employer Phone
From:
*

To:
*
*

*
*

Job Title Supervisor Name & Title May we Contact?
*
*

*
*
Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
*
*
Start:
*

End:
*
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
*
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 2

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 3

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 4

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 5

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 6

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 7

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 8

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 9

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:

EMPLOYER 10

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:
WERE YOU SUBJECT TO THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS?
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
ACCOUNT FOR PERIOD BETWEEN JOBS - Include dates (month/year) and reason:


EDUCATION & TRAINING BACKGROUND
* Select highest school year completed?:College:
* Name of Last School Attended:
* Address of Last School Attended:
List any currently valid motor vehicle or equipment operator licenses or trade certifications you hold:

ACCIDENT RECORD (PAST THREE YEARS)
If no accidents within the last 3 years

Location Date Nature of Accident
(Head-on, Rear-End, Upset, Etc.)
Injuries Fatalities Property Damage

TRAFFIC CONVICTIONS AND FORFEITURES (PAST THREE YEARS)
If no Traffic Convictions and/or Forfeitures within the last 3 years

Location Date Charge Penalty

DRIVING EXPERIENCE
If no driving experience within the last 3 years

Class of Equipment   Check Type of Equipment Date From(M/Y) Date To(M/Y) Approx No. of Miles (Total)
* Straight Truck
Yes
No
* Tractor or Semi-Trailer
Yes
No
Other:  

* List states driven in the last five years:
* List safe driving award and any applicable safety training certificates received:

ACTIVITES, ADDITIONAL INFORMATION, AND COMMENTS
* List present and past membership in civic, professional, social or other organizations, sports, hobbies, and other interests (exclude those which indicate race, color, sex, age, national origin, disability, religious preference, or marital status).
* Have you tested positive, or refused to test, on any drug and/or alcohol test administered by any employer for safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past three years?
Yes   No
* Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for but did not obtain safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the last two years?
Yes   No
In accordance with the provisions of Section 604(b)(2)(A) of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996, you are being informed that reports verifying your previous employment, previous drug and alcohol test results, and your driving record will be obtained on you for employment purposes. These reports are required by Sections 382.413, 391.23, and 391.25 of the Federal Motor Carrier Safety Regulations.

I authorize The New Bakery Company of Ohio, Inc., to prepare and obtain consumer reports including but not limited to information as to my personal, employment, accident, financial, medical, and/or driving history and other related matters as may be necessary. I understand that The New Bakery Company of Ohio, Inc., may obtain this information from credit reporting agencies or state agencies. Such reports may contain public record information from federal, state, and other agencies which maintain such records.

I have the right to receive, upon my written request within a reasonable period of time, a complete and accurate disclosure of the nature and the scope of the investigation requested. I have the right to have errors corrected by the previous employer, and I have the right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and I cannot agree on the accuracy of the information.


TO BE READ AND SIGNED BY APPLICANT
I authorize you to make sure investigations and inquires to my personal, employment, financial, or medical 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 and other persons from all liability in responding to inquires 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 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 employers; 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."
This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.

* Applicant's Signature (type name):* Date:

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