Apply for Truck Delivery Driver Class A CDL-OTR-Chicago Logistics

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Truck Delivery Driver Class A CDL-OTR-Chicago Logistics
ID:1070
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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Application for Employment - Eastbalt
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. WE DO NOT BASE OUR EMPLOYMENT DECISIONS ON AN EMPLOYEE'S OR APPLICANT'S RACE, COLOR, CREED, SEX, SEXUAL ORIENTATION, AGE, RELIGION, NATIONAL ORIGIN, CITIZENSHIP, DISABILITY, HANDICAP, OR ANY OTHER FACTOR PROHIBITED BY LOCAL, STATE OR FEDERAL LAW

To the Applicant: Certain of the information requested below is required by the U.S. Department of Transportation (DOT) regulations. We may investigate all of the information provided below, including but not limited to the driver safety performance history information you provide us, and contact your previous employers for the purpose of evaluating this information and your Application. In completing this Application, you consent to the Company doing so.


PERSONAL INFORMATION
* Social Security No
* Date of Birth
* Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment)
Yes   No
* Are you legally eligible for employment in the United States? (Proof will be required if hired.)
Yes   No
* Are you less than 21 years of age? (We comply with DOT regulations.)
Yes   No
Describe any job-related training received in the United States Military. (Colorado applicants need not provide information regarding military service.)

Person(s) to contact in case of an emergency:
Name Home Phone Work Phone Relationship

* Please indicate whether you speak and understand the English language
Yes   No
* Please indicate whether you read and write English
Yes   No

EMPLOYMENT DESIRED
* How did you hear about the position?
Advertisement
Walk In
Employee or Relative
Employment Agency
Other
* Are you applying for
Regular Full-time Work
Regular Part-time Work
Temporary Work
* If hired, on what date can you start work?
* Depending on customer demands, this position may require availability to work on any of the seven (7) days of a given week.  Are there any days on which you are unavailable to work?
Yes   No
If yes, which days of the week are you unavailable to work?
* Have you applied for employment with East Balt. Commissary, Inc. before?
Yes   No
If yes, date
* Have you worked with East Balt. Commissary, Inc. in the past?
Yes   No
If yes, dates employed
Job Duties
Reason for leaving
* Do you know anyone currently working for East Balt. Commissary, Inc.?
Yes   No
If yes, please state name and relationship to you



Please list all other addresses where you have resided during the last three years:
Street City State & Zip Code How Long?



* Do you have a Commercial Motor Vehicle License (CMV)?
Yes   No
* Do you have more than one (1) CMV License?
Yes   No

Please list issuing State, license number and expiration date of each unexpired CMV license or permit you have been issued:
State License No. Type Expiration Date

EMPLOYMENT AND SAFETY HISTORY
Please list each employer you have worked for during the last three years. List the most recent (or present) employer first.
Note that if you have had DOT-regulated employment during the preceding three years, you have the right to review information provided by previous employers; the right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to East Balt. Commissary, Inc.; and the right to have a rebuttal statement attached to the alleged erroneous information, if you and your previous employer cannot agree on the accuracy of the information.

* Are you employed now?
Yes   No
* May we contact your present employer?
Yes   No
* May we contact your prior employers?
Yes   No


EMPLOYER 1

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Supervisor & Title Job Title

Description of job and duties Reason for Leaving Wage Rate or Salary
Start:

Final:
Was this position subject to the Federal Motor Carrier Safety Regulations?
Yes   No
Was your job designated as a safety sensitive function subject to alcohol and controlled substance testing requirements specified by 49 Code of Federal Regulations (CFR) Part 40?:
Yes   No

EMPLOYER 2

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Supervisor & Title Job Title

Description of job and duties Reason for Leaving Wage Rate or Salary
Start:

Final:
Was this position subject to the Federal Motor Carrier Safety Regulations?:
Yes   No
Was your job designated as a safety sensitive function subject to alcohol and controlled substance testing requirements specified by 49 Code of Federal Regulations (CFR) Part 40?:
Yes   No


EMPLOYER 3

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Supervisor & Title Job Title

Description of job and duties Reason for Leaving Wage Rate or Salary
Start:

Final:
Was this position subject to the Federal Motor Carrier Safety Regulations?:
Yes   No
Was your job designated as a safety sensitive function subject to alcohol and controlled substance testing requirements specified by 49 Code of Federal Regulations (CFR) Part 40?:
Yes   No

EMPLOYER 4

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Supervisor & Title Job Title

Description of job and duties Reason for Leaving Wage Rate or Salary
Start:

Final:
Was this position subject to the Federal Motor Carrier Safety Regulations?:
Yes   No
Was your job designated as a safety sensitive function subject to alcohol and controlled substance testing requirements specified by 49 Code of Federal Regulations (CFR) Part 40?:
Yes   No

EMPLOYER 5

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Supervisor & Title Job Title

Description of job and duties Reason for Leaving Wage Rate or Salary
Start:

Final:
Was this position subject to the Federal Motor Carrier Safety Regulations?:
Yes   No
Was your job designated as a safety sensitive function subject to alcohol and controlled substance testing requirements specified by 49 Code of Federal Regulations (CFR) Part 40?:
Yes   No




* In the seven years prior to the above three year employment history you provided, have you operated a Commercial Motor Vehicle (CMV) for any employer?:
Yes   No

If yes, please list all employers for whom you have operated a CMV in the seven years previous to the above.
EMPLOYER 6

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Reason for Leaving Final Salary

EMPLOYER 7

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Reason for Leaving Final Salary

EMPLOYER 8

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Reason for Leaving Final Salary

EMPLOYER 9

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Reason for Leaving Final Salary

EMPLOYER 10

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Reason for Leaving Final Salary

EMPLOYER 11

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Reason for Leaving Final Salary

EMPLOYER 12

Dates Employed Employer Name & Address Phone Number
From:

To:

Type of Business Reason for Leaving Final Salary

Please list your experience in the operation of motor vehicles, including the type of equipment, (such as buses, trucks, truck tractors, semitrailers, full trailers and pole trailers) and the length of experience on each.


ACCIDENT AND VIOLATION RECORD
Please list all motor vehicle accidents in which you have been involved during the last three years:

Date Nature of Accident Fatalities Injuries

Please list all violations of motor vehicle laws or ordinances (other than violations involving only parking) of which you were convicted or forfeited bond or collateral during the last three years
If you have ever been denied or have had revoked or suspended, any license, permit or privilege to operate a motor vehicle, please set forth in detail the facts and circumstances of any such denial, revocation or suspension
If not, please state that no such denial, revocation or suspension has occurred


EDUCATIONAL BACKGROUND
  Name City, State Subjects Studied # Yrs Attended Did you Graduate?
High School
Yes
No
College/University
Yes
No
Other (Vocational, Trade, Graduate, Etc.)
Yes
No

Please provide any additional information that you believe would assist us in better evaluating your application

REFERENCES Please list three people, who are not related to you and who are not previous supervisors, that you have known for at least one year, and whom we may contact as additional references.

Name Relationship Years Known Phone No. Address

APPLICANT'S STATEMENT
I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any false statements, omissions or misrepresentations on this application or made during the employment process may be considered sufficient cause for rejection of this application or dismissal if I have been employed, no matter when discovered by the Company. I also understand and agree that all information is subject to verification.

I hereby authorize East Balt. Commissary, Inc. to thoroughly investigate my background, (criminal, credit, etc.) references, employment record and other matters related to my suitability for employment, and further authorize my former employers and any third party to disclose to East Balt. Commissary, Inc. all reports and other information related to my suitability for employment, personal or otherwise, without giving me prior notice of such disclosure. In addition, I hereby release East Balt. Commissary, Inc., all former employers, and all references listed above, from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure. I hereby authorize East Balt. Commissary, Inc. and any consumer or credit reporting agency or bureau employed by the Company to make a consumer credit report in connection with this application.

I understand that if I receive an offer of employment, it will be conditioned on my passing a drug/alcohol test, a job-related physical examination and all other pre-hire requirements. I further understand that, should this test indicate the presence of drugs in my system or that I am under the influence of alcohol, it may result in the rejection of my application for employment or my immediate discharge, if detected, discovered or reported after hire. I consent to this testing and examination and request that the results of such test(s) and examination be disclosed to the Company, and I hereby release the Company, its employees and its agents from any and all legal liability flowing from my taking such test(s) and examination or my failure or refusal to take such test(s) or examination. I also understand that if the physical examination discloses a medical condition(s) that prevents me from performing the essential functions of the position(s) I am applying for, the Company will attempt to make an accommodation to allow me to work in the position(s) for which I am applying. If there is no reasonable accommodation which can be made without undue hardship to the Company, I understand that my application for employment may be rejected or I may be discharged, if I have already begun working for the Company. The Company complies with all applicable laws in these areas.

I understand that nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract. I further agree that if I am hired, my employment is for no definite period and may be terminated at any time, without prior notice, at the option of either myself or the Company (Union employees are governed by the terms of their Union Contract). I further understand that no representative of the Company, other tha

n one of the Officers of the Company, has any authority at any time, to enter into any agreement of employment. I understand that employment is contingent upon my complying with the employment verification requirements of the Immigration Reform and Control Act.

If hired, I agree to abide by all Company work rules, policies and procedures relating to work performance and conduct.

I understand that the Company will consider this application only for up to 30 days, and that I will have to complete a new application if I want to be considered for employment after that period of time.

This certifies that this Employment Application was completed by me, and that all entries on it and information contained in it are true and complete to the best of my knowledge.

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

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