KIT Transportation Driver Application

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, military or veteran status, or disability.

Personal Information

First Name*

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Middle Name

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Last Name*

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Email*

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Phone*

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Type*

Cell

Home

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Street Address*

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Address 2

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City*

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State*

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Zip*

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How long have you lived at this address?*

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Have you lived at another address in the last 3 years?*

Yes

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Please list all residencies in the last three years.

Street Address

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Address 2

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City

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State

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Zip

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How long did you live at this address?

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Do you have another address to list?

Yes

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Street Address

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Address 2

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City

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State

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Zip

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How long did you live at this address?

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Do you have another address to list?

Yes

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Street Address

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Address 2

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City

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State

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Zip

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How long did you live at this address?

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

Yes

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Date of Birth*

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Can you provide proof of age?*

Yes

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Have you worked with us before?*

Yes

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Please provide dates, position, and reason for leaving.

Start date of employment

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End date of employment

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Position

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Reason for leaving

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Are you employed now?*

Yes

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End date of last employment

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Who referred you?

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Rate of pay expected

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Have you ever been convicted of a felony?*

Yes

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Please explain your conviction(s)

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

Yes

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Explain why, if you wish

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Employment History

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. 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 the applicant operated such vehicle. (Note: List employers in reverse order starting with the most recent. Add another sheet if necessary

Employer 1

Employer Name

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Employer Contact / Supervisor

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Employer Phone

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Address

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City

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State

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Zip

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Position Held

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Salary/Wage

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Start Date

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End Date

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Reason for leaving

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Were you subject to FMCSR regulations while employed?

Yes

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Was this job designated as a safety sensitive function in which you were subject to alcohol and controlled substance testing?

Yes

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Do you have another employer to add?

Yes

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Employer 2

Employer Name

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Employer Contact / Supervisor

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Employer Phone

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Address

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City

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State

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Zip

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Position Held

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Salary/Wage

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Start Date

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End Date

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Reason for leaving

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Were you subject to FMCSR regulations while employed?

Yes

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Was this job designated as a safety sensitive function in which you were subject to alcohol and controlled substance testing?

Yes

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Do you have another employer to add?

Yes

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Employer 3

Employer Name

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Employer Contact / Supervisor

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Employer Phone

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Address

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City

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State

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Zip

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Position Held

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Salary/Wage

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Start Date

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End Date

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Reason for leaving

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Were you subject to FMCSR regulations while employed?

Yes

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Was this job designated as a safety sensitive function in which you were subject to alcohol and controlled substance testing?

Yes

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Do you have another employer to add?

Yes

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Employer 4

Employer Name

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Employer Contact / Supervisor

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Employer Phone

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Address

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City

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State

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Zip

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Position Held

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Salary/Wage

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Start Date

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End Date

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Reason for leaving

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Were you subject to FMCSR regulations while employed?

Yes

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Was this job designated as a safety sensitive function in which you were subject to alcohol and controlled substance testing?

Yes

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Do you have another employer to add?

Yes

Invalid Input

Employer 5

Employer Name

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Employer Contact / Supervisor

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Employer Phone

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Address

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City

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State

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Zip

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Position Held

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Salary/Wage

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Start Date

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End Date

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Reason for leaving

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Were you subject to FMCSR regulations while employed?

Yes

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Was this job designated as a safety sensitive function in which you were subject to alcohol and controlled substance testing?

Yes

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Driving Record - Last 3 Years

How many accidents have occurred in the last 3 years?*

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Date of accident

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Nature of accident

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Fatalities

Yes

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Injuries

Yes

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Hazmat Spill

Yes

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Date of accident

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Nature of accident

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Fatalities

Yes

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Injuries

Yes

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Hazmat Spill

Yes

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Date of accident

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Nature of accident

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Fatalities

Yes

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Injuries

Yes

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Hazmat Spill

Yes

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Please be prepared to provide any other accident records.

How many traffic convictions or forfeitures (other than parking violations) have occurred in the last 3 years?*

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Date

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Location

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Charge

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Penalty

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Date

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Location

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Charge

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Penalty

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Date

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Location

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Charge

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Penalty

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Please be prepared to provide any other traffic convictions or forfeitures.

Experience and Qualifications

How many drivers licenses or permits have you held in the past 3 years?

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

Yes

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Has any license, permit, or privilege ever been revoked?*

Yes

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Please provide details about why it was denied or revoked.

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Driving Experience

Equipment Class: Straight Truck, Tractor Trailer, Doubles, Triples, Motor Coach, Bus, or Other

Type of Equipment

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Date From

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Date To

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Approx. number of miles

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Type of Equipment

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Date From

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Date To

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Approx. number of miles

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Type of Equipment

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Date From

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Date To

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Approx. number of miles

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List States operated in for the past 5 years

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

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List any courses and training other than shown elsewhere in this application

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What is the highest level of education have you completed?*

Primary

High School

College

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What grade have you completed?*

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What grade have you completed?*

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How many years have you completed?*

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Last School Attended

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City

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State

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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 true and complete to the best of my knowledge.

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 inquires 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 may result in discharge. I understand, also, that I am required to abide by all rules and regulation of the Company.

I have read and agree to the above terms*

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K.I.T. Transportation, Inc.

PO Box 310 | Hannacroix, NY 12087

KIT Transportation Driver Application

Personal Information

Employment History

Employer 1

Employer 2

Employer 3

Employer 4

Employer 5

Driving Record - Last 3 Years

Experience and Qualifications

Driving Experience

To Be Read and Signed by Applicant