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General Application

    Application for Employment

    We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, sexual orientation, marital status, genetic information or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions are based on job-related factors.

    Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

    General Information

    Type of employment you are seeking: Full-timePart-timeTemporary

    Current Address

    If hired, you will be required to furnish proof of your eligibility to work in the U.S.

    Have you ever applied here before? YesNo

    If yes, when?

    Were you employed here before? YesNo

    If yes, when?

    If employed, do you expect to be engaged in any additional business or employment outside of our job? YesNo

    Education

    High School or GED

    College or University

    Vocational or Technical

    Special Skills

    What skills or additional training do you have that are related to the job for which you are applying?

    What machines or equipment can you operate that are related to the job for which you are applying?

    For Driving Jobs Only: Do you have a valid drivers license? YesNoNot applying for a driving job

    If you answered "Yes", please provide:

    Have you have your drivers license suspended or revoked in the last 3 years? YesNo

    List professional, trade, business or civic activities and offices held.

    Work History

    List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references.

    Note: A job offer may be contingent upon acceptable references from current and former employers.

    Most Recent Employer

    Second Most Recent Employer

    Third Most Recent Employer

    Fourth Most Recent Employer

    References

    Have you worked or attended school under any other names? YesNo

    Are you presently employed? YesNo

    Have you ever been fired from a job or asked to resign? YesNo

    Please list your references

    AFFIDAVIT,CONSENT AND RELEASE

    PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

    I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my
    dismissal if discovered at a later date.

    I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers, and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

    I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre and/or post-employment drug screen as a condition of employment, if required.

    I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

    I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.

    I have read, understand, and by my signature consent to these statements.

    This application for employment will remain active for a limited time.
    Ask the organization’s representative for details.

    CDL Application

      General Information

      Current Address

      Previous Address(s) (Please list address's for the past 3 years)

      Do you have the legal right to work in the United States? YesNo

      Can you provide proof of age? YesNo

      Have you ever worked for Trax Construction before? YesNo

      If yes, please answer the following:

      Are you currently employed? YesNo

      Have you ever been bonded? YesNo

      Is there any reason you might be unable to perform the functions of the job for which you have applied? YesNo

      Employment History

      All driver applicants to drive interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code.

      Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years' information on those employers for whom those applicants operated such vehicle.

      Most Recent Employer

      Where you subject to the FMCSRs** while employed? YesNo

      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?
      YesNo

      Second Most Recent Employer

      Where you subject to the FMCSRs** while employed? YesNo

      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?
      YesNo

      Third Most Recent Employer

      Where you subject to the FMCSRs** while employed? YesNo

      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?
      YesNo

      Fourth Most Recent Employer

      Where you subject to the FMCSRs** while employed? YesNo

      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?
      YesNo

      *Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity regarding 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 GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

      Motor Vehicle History

      Accident Record

      Include the following details about all accidents for the past 3 years. Please list accidents in order from most recent to least recent. If none, skip this section.

      Accident #1

      Accident #2

      Accident #3

      Accident #4

      Traffic Convictions

      Include all traffic convictions and forfeitures for the past 3 years. Please list in order from most recent to least recent. If none, skip this section.

      Drivers Licenses or Permits

      Include all drivers licenses or permits held in the past 3 years.

      Have you ever been denied a license, permit or privilege to operate a motor vehicle? YesNo

      Has any license, permit or privilege been suspended or revoked? YesNo

      Driving Experience

      Straight Truck

      Experience with: YesNo

      Type of Equipment: VanTankFlatDumpRefer

      Tractor or Semi-Trailer

      Experience with: YesNo

      Type of Equipment: VanTankFlatDumpRefer

      Tractor - Two Trailers

      Experience with: YesNo

      Type of Equipment: VanTankFlatDumpRefer

      Tractor - Three Trailers

      Experience with: YesNo

      Type of Equipment: VanTankFlatDumpRefer

      Motorcoach - School Bus (more than 8 people)

      Experience with: YesNo

      Motorcoach - School Bus (more than 15 people)

      Experience with: YesNo

      Additional Info:

      Experience & Qualifications

      Education

      Please checkmark the highest grade completed: 12345678910111213141516

      To Be Read and Signed By Applicant

      I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries 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 inquiries 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 investigation of 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 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.

      I certify that this application was completed by me, and that all entries on it are true and complete to the best of my knowledge.

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