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Drivers please read before applying

Before embarking on your journey as a new driver, it's essential to understand that obtaining a DOT Medical Examiner's Certificate is a prerequisite for hitting the road. This certificate serves as a crucial requirement for those considering a career in driving, as it verifies your physical fitness to operate commercial vehicles. If you're hired for a driving position, you'll be required to obtain this certificate if you haven't already. The process involves a medical evaluation conducted by a certified medical examiner to ensure you meet the necessary health standards. While costs may vary, typically it is around $100 and many Urgent Care clinics offer this service. Please be prepared to get this Certificate, if you do not already have one, if you are accepted as a driver.

You must also be prepared to pull your own NC Driving Record at the cost of $13.75. If you do not have a NC driver's license, you would have to pull the one for your state license if you are accepted as a driver. If you are unsure of your driving record, please pull it before you apply to verify you have a good record and your license is in good standing, otherwise it will be needed before the final acceptance. Here is the link for the NC Driving Record Requests.

Official NCDMV: Online Services (ncdot.gov)

Legal First Name *

Last Name *

Full Address *

City, State Zip *

Cell Number *

Email *

Date of birth *

Emergency Contact *

Contact Number *

If your address above is less than 3 years continue listing them below to cover the pervious 3 year period:

Full Address -1

Full Address - 2

Driver’s License Information: all licenses held, last 3 years:

Driver’s License State - 1

Driver’s License Number - 1

Driver’s License Exp Date - 1

Driver’s License State - 2

Driver’s License Number - 2

Driver’s License Exp Date - 2

Experience:

Experience: Types of vehicles driven

List Last Accident: (If none, write NONE)

Accident Date

Accident - Describe

Have you had a accident with fatalities?

Have you had an accident with injuries?

Have you ever had any driver license denied, suspended, revoked or canceled by any issuing state agency?

Yes

No

If yes: state of issuance; explanation:

Employment History, last 5 years – account for gaps between employers: (If owner/operator, list carriers leased to)

Employment History, Employer 1

Dates of Employment

Address

City, State Zip

Supervisor

Phone

Were you subject to the Federal Motor Carrier Safety Regulations during this period? 1

Yes

No

Were you subject to 49 CFR part 40 controlled substance and alcohol test during this period? 1

Yes

No

Reason for Leaving

Employment History, Employer 2

Dates of Employment 2

Address

City, State Zip

Supervisor

Phone

Were you subject to the Federal Motor Carrier Safety Regulations during this period? 2

Yes

No

Were you subject to 49 CFR part 40 controlled substance and alcohol test during this period? 2

Yes

No

Reason for Leaving

Employment History, Employer 3

Dates of Employment 3

Address

City, State Zip

Supervisor

Phone

Were you subject to the Federal Motor Carrier Safety Regulations during this period? 3

Yes

No

Were you subject to 49 CFR part 40 controlled substance and alcohol test during this period? 3

Yes

No

Reason for Leaving

References: List 3 Family Members or Friends you can use as a Reference.

Reference 1 *

Ref 1 number *

Address Ref 1 *

Ref1 City State Zip *

Relationship of ref 1 *

Reference 2 *

Ref 2 number *

Address Ref 2 *

Ref2 City, State Zip

Relationship of ref 2 *

Reference 3 *

Address Ref 3 *

Ref3 City State Zip *

Ref 3 number *

Relationship Ref 3 *

The position you are applying for is a 1099 Contract Driver. Pay will be by percentage of the load negotiated based on your experience, driving record and qualifications. If hired, you will need to provide a drug test paid for by you or your company – so do not apply if you are not serious about this work opportunity.

“I certify that is 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. By signing my name below, I agree to this.”

Date Signed *

Signature *

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Weekends Closed

JAMESTOWN, NC USA

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