Drivers Application For Employment

Bullet Trucking, Inc.
7651 Center Point 70 Blvd
Dayton, OH 45424

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.

(answer all questions - please print)

Date of Application:

Position Applied For:

Name:

Last

First

Middle

Social Security No:

Current Address:

Address
City	State	Zip
Phone	How Long

Previous Addresses:
(Last 3 Years)

Address	City	State	Zip	How Long
Address	City	State	Zip	How Long
Address	City	State	Zip	How Long

Do you have the legal right to work in the United States? Yes No

Date of Birth:

Can you provide proof of age? Yes No

Is there any reason you might be unable to perform the functions of the job for whigh you have applied? Yes No
If yes, explain if you wish.

Employment History

All driver applicants to drive in 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 (Includes: vehicles having a GVWR of 26,001 or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in any quantity requiring placarding) in interstate or intrastate commerce shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle.

List employers in reverse order starting with the most recent.

Employer 1:			Date:
Name:			From Month/Year: /	To Month/Year: /
Address:			Position:
City:	State:	Zip:	Salary:
Contact:	Phone:		Reason For Leaving:

Employer 2:			Date:
Name:			From Month/Year: /	To Month/Year: /
Address:			Position:
City:	State:	Zip:	Salary:
Contact:	Phone:		Reason For Leaving:

Employer 3:			Date:
Name:			From Month/Year: /	To Month/Year: /
Address:			Position:
City:	State:	Zip:	Salary:
Contact:	Phone:		Reason For Leaving:

Employer 4:			Date:
Name:			From Month/Year: /	To Month/Year: /
Address:			Position:
City:	State:	Zip:	Salary:
Contact:	Phone:		Reason For Leaving:

Employer 5:			Date:
Name:			From Month/Year: /	To Month/Year: /
Address:			Position:
City:	State:	Zip:	Salary:
Contact:	Phone:		Reason For Leaving:

Employer 6:			Date:
Name:			From Month/Year: /	To Month/Year: /
Address:			Position:
City:	State:	Zip:	Salary:
Contact:	Phone:		Reason For Leaving:

Employer 7:			Date:
Name:			From Month/Year: /	To Month/Year: /
Address:			Position:
City:	State:	Zip:	Salary:
Contact:	Phone:		Reason For Leaving:

Experience and Qualifications - Other

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

List courses or training other than shown elsewhere on this application.

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

To be read and signed by applicant.

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

I authorize you to make such investigations and inquiries of my personal, financial, employment 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 any liability in responding to inquiries and releasing information in connection with this 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.

Date:
Email Address:
Signature: (Type Full Name)