417-246-1203 info@cmtboats.com

Application For Employment-Online Form



In Compliance With Federal & State Equal Employment Opportunity Laws, Qualified Applicants Are Considered For All Positions Without Regard To Race, Color, Religion, Sex, National Origin, Age, Marital Status, Veteran Status, Non-Job Related Disability, Or Any Other Protected Group Status.


BASIC INFORMATION



















Yes

No



Yes

No




EDUCATION







PREVIOUS THREE YEARS RESIDENCY


FIRST PREVIOUS RESIDENCY








SECOND PREVIOUS RESIDENCY








THIRD PREVIOUS RESIDENCY










EMERGENCY CONTACT INFORMATION






LICENSE INFORMATION

Section 383.21 FMCSR States, "No Person Who Operated A Commercial Motor Vehicle Shall At Any Time Have More Than One Driver's License". I Certify That I Do Not Have More Than One Motor Vehicle License, The Information For Which Is Listed Below.









DRIVING EXPERIENCE


CLASS OF EQUIPMENT: STRAIGHT TRUCK









CLASS OF EQUIPMENT: TRACTOR & SEMI-TRAILER









CLASS OF EQUIPMENT: TRACTOR (TWO TRAILERS)









CLASS OF EQUIPMENT: OTHER









ACCIDENT RECORD FOR PAST 3 YEARS OR MORE


FIRST ACCIDENT RECORD







Yes

No




SECOND ACCIDENT RECORD







Yes

No




THIRD ACCIDENT RECORD









TRAFFIC CONVICTIONS & FORFEITURES FOR THE PAST THREE YEARS


FIRST CONVICTION/FORFEITURE









SECOND CONVICTION/FORFEITURE









THIRD CONVICTION/FORFEITURE









FOURTH CONVICTION/FORFEITURE







A. Have You Ever Been Denied A License, Permit or Privilege To Operate A Motor Vehicle?
Yes

No



B. Has Any License, Permit Or Privilege Ever Been Suspended Or Revoked?
Yes

No





EQUIPMENT INFORMATION











EMPLOYMENT HISTORY


*DOT Requires That Employment History For At Least The Previous 10 Years Be Provided

• List Names & Addresses Of Previous Employers For Which The Applicant Was An Operator Of A Commercial Motor Vehicle;

• The Dates The Applicant Was Employed By These Employers;

• The Reason For Leaving Such Employment.

*Any Gaps In Employment And/Or Unemployment Must Be Explained; Include Dates (Month/Year) & Reason For Any Gaps


LAST EMPLOYER














Yes

No



Yes

No




2ND LAST EMPLOYER














Yes

No



Yes

No




3RD LAST EMPLOYER














Yes

No



Yes

No




4TH LAST EMPLOYER














Yes

No



Yes

No




OTHER INFORMATION



Yes

No



Yes

No



Yes

No



Yes

No






PLEASE USE YOUR FINGER OR MOUSE TO SIGN BELOW IN THE PROVIDED BOX




CONTACT INFORMATION