Drivers
Introduction
Driver Benefits
Driver Requirements
Driver Equipment (Pick-up)
Download Driver App
On-line Driver App
Download Pickup Worksheet
Recreational Vehicle Driver On-line Application
Date of Application:
First Name:
Last Name:
Current Address:
City:
State:
Zip:
Home Phone #:
Cell Phone #:
Email Address:
Social Security #:
If current residency is less than 3 years, please include additional addresses for the past 3 years.
Previous Address:
City:
State:
Zip:
Previous Address:
City:
State:
Zip:
Do you have a legal right to work in the United State of America?
Yes
No
Date of Birth (xx/xx/xxxx):
Can you provide proof of age?
Yes
No
Have you worked for Star Fleet before?
Yes
No
If Yes, Where:
Dates From/To:
Position:
Reason for leaving:
Are you emplyed now?
Yes
No
If No, how long since leaving your last employment?:
Who Referred You?:
Were you subject to the Federal Motor Carrier Safety Regulations by your previous employer?
Yes
No
Was your job designated as a safety sensitive position? (You would have been subject to FMCSR Drug and Alcohol Testing):
Yes
No
Is there any reason you might not be able to perform the functions of the job for which you have applied?
Yes
No
If Yes, explain:
Employment History
Name:
Date From/To:
Address:
Position Held:
City:
Salary/Wage:
State:
Zip:
Phone:
Contact:
Reason for Leaving:
Name:
Date From/To:
Address:
Position Held:
City:
Salary/Wage:
State:
Zip:
Phone:
Contact:
Reason for Leaving:
Name:
Date From/To:
Address:
Position Held:
City:
Salary/Wage:
State:
Zip:
Phone:
Contact:
Reason for Leaving:
Name:
Date From/To:
Address:
Position Held:
City:
Salary/Wage:
State:
Zip:
Phone:
Contact:
Reason for Leaving:
Name:
Date From/To:
Address:
Position Held:
City:
Salary/Wage:
State:
Zip:
Phone:
Contact:
Reason for Leaving:
Name:
Date From/To:
Address:
Position Held:
City:
Salary/Wage:
State:
Zip:
Phone:
Contact:
Reason for Leaving:
Name:
Date From/To:
Address:
Position Held:
City:
Salary/Wage:
State:
Zip:
Phone:
Contact:
Reason for Leaving:
Accident Record for the Past 3 Years
Date
Nature of Accident
Fatalities
Injuries
Traffic Convictions Moving Violoations for the past 3 years
Date
Location
Charge
Injuries
Education
Highest Grade Completed
Grade School - 1st
Grade School - 7th
College - Freshman
Grade School - 2nd
Grade School - 8th
College - Sophomore
Grade School - 3rd
High School - 9th
College - Junior
Grade School - 4th
High School - 10th
College - Senior
Grade School - 5th
High School - 11th
College - Graduate School
Grade School - 6th
High School - 12th
Drivers License Information:
State
License Number
Type
Expiration Date
A) Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Yes
No
B) Has any license, permit or driving privilege ever been suspended or revoked?
Yes
No
If the answer to either A or B is yes, please give details:
Driving Experience
Class of Equipment:
Start Date:
End Date:
Approx # of Total Miles:
Straight Truck
Tractor-Semi Trailer
Motor Coach School Bus
5th Wheel RV
Other
List all states operated in the last five years:
List special courses or training that you have taken that will help you as a driver:
Which Safe Driving Awards do you hold and from whom?
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. I authorize you to make such investigations and inquireies of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. In the event of my employment, I understand that false or misleading information given in my application or interviews may result in discharge. I also understant that I am required to abide by all rules and regulations of the company.
P.O. Box 830, Middlebury, Indiana 46540 Phone: 1-888-281-8727 * Fax: (574) 825-9700
2005 Copyright Star Fleet Trucking, Inc.