Kandel Transport Inc. - Driver Employment Application

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disability.

General Information

Position(s) Applied for

First name *

Middle initial

Last name *

Phone *

Your Email Address *

Please fill in phone or email - at least one of them is required.

Date of birth *

Required for Commercial Drivers

Addresses Of Residency For The Past 3 Years

Current Address

Street Address

City

State

Zip

Previous Address 1

Street Address

City

State

Zip

How long

Previous Address 2

Street Address

City

State

Zip

How long

Check here if you have the legal right to work in the United States.

Check here if you can provide proof of age.

Check here if you have ever worked for this company before.

Please answer the below questions regarding your previous employment at Kandel:

Where

Dates: From

Rate of Pay

Position

Reason for leaving

Check here if you are now employed.

Who referred you?

Check here if there is any reason you might be unable to perform the functions of the job for which you have applied.

If the above answer is yes, explain if you wish:

Reason

Employment History

List complete mailing address, street number, city, state and zip code. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall provide 10 years' information on those employers for whom the applicant operated such vehicle.

Current (or Previous) Employer 1

Name

Address

City

State

Zip

Contact Person

Phone

From month

From year

To month

To year

Position Held

Salary/Wage

Reason for leaving

Check here if you were subject to the FMCSRs** while employed.

Check here if your job was designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40.

Previous Employer 2

Name

Address

City

State

Zip

Contact Person

Phone

From month

From year

To month

To year

Position Held

Salary/Wage

Reason for leaving

Check here if you were subject to the FMCSRs** while employed.

Check here if your job was designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40.

Previous Employer 3

Name

Address

City

State

Zip

Contact Person

Phone

From month

From year

To month

To year

Position Held

Salary/Wage

Reason for leaving

Check here if you were subject to the FMCSRs** while employed.

Check here if your job was designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40.

Previous Employer 4

Name

Address

City

State

Zip

Contact Person

Phone

From month

From year

To month

To year

Position Held

Salary/Wage

Reason for leaving

Check here if you were subject to the FMCSRs** while employed.

Check here if your job was designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40.

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

**The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in Interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport 9 or more passengers, OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

Accident Record

For the past 3 years or more.

Last Accident

Date

Nature of accidentHead-on, rear-end, upset, etc.

Fatalities

Injuries

Next Accident 1

Date

Nature of accidentHead-on, rear-end, upset, etc.

Fatalities

Injuries

Next Accident 2

Date

Nature of accidentHead-on, rear-end, upset, etc.

Fatalities

Injuries

Traffic Convictions and Forfeitures

For the past 3 years or more (other than parking violations).

Incident 1

Location

Date

Charge

Penalty

Incident 2

Location

Date

Charge

Penalty

Incident 3

Location

Date

Charge

Penalty

Education

Choose highest grade completed

Elementary School

High School

College

Last School Attended Name

City

Experience and Qualifications - Driver

Driver's License 1

State

License Number

Type

Expiration

Driver's License 2

State

License Number

Type

Expiration

Driver's License 3

State

License Number

Type

Expiration

A. Check here if you have ever been denied a license, permit, or privilege to operate a motor vehicle.

B. Check here if you have ever had any license, permit, or privilege suspended or revoked.

If the anwser to either A or B above is yes, please give details

Driving Experience

Straight Truck

Type of Equipment(van, tank, flat, etc.)

Date from

Date to

Approximate number of miles (total)

Tractor and Semi-trailer

Type of Equipment(van, tank, flat, etc.)

Date from

Date to

Approximate number of miles (total)

Tractor and two trailers

Type of Equipment(van, tank, flat, etc.)

Date from

Date to

Approximate number of miles (total)

Other

Type of Equipment(van, tank, flat, etc.)

Date from

Date to

Approximate number of miles (total)

List states operated in for last five years

Show special courses or training that will help you as a driver

Which safe driving awards do you hold and from whom?

Show any trucking, transportation or other experience that may help in your work for this company

List courses and training other than shown elsewhere in this application

List special equipment or technical materials you can work with (other than those already shown)

Last 4 of SS# *Last 4 digits of your Social Security #, required for the following license # check.

By clicking here you acknowledge that you agree to driver’s license check consent. *

By clicking here you acknowledge that you agree to this applicant agreement. *

By clicking here you acknowledge that you agree to allow Kandel Transport to access the FMCSA Pre-Employment Screening Program. *

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