DRIVER'S APPLICATION FOR EMPLOYMENT

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, veteran status, non-job related disability, or any other protected group status.

Position

Have you worked for Regal before?

Rate of Pay expected ?

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

Can you provide proof of age?

Are you currently employed?

How long since last employed?

First Name

Last Name

Middle Name

List your addresses of residency for the past 3 years

Current Address

Street

City

State

Zip Code

How long? (yr./mo)

Previous Addresses

Street

City

State

Zip Code

How long? (yr./mo)

Street

City

State

Zip Code

How long? (yr./mo)

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 (CMV)* in intrastate or interstate commerce shall also provide an additional 7 years of employment history. (NOTE: List employers in reverse order starting with the most recent employer.)

The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

Employer/Company

Company Address

City

State

Zip

Start Date (mo/yr.)

End Date (mo/yr.)

Position Held

Salary/Wage

Reason for leaving

Supervisor or Contact Person

Phone Number

Was your job duties commercially driving related?

Was your job duties DOT-Regulated?

Additional Employment

Employer/Company

Company Address

City

State

Zip

Start Date (mo/yr.)

End Date (mo/yr.)

Position Held

Salary/Wage

Reason for leaving

Supervisor or Contact Person

Phone Number

Was your job duties commercially driving related?

Was your job duties DOT-Regulated?

Additional Employment

Employer/Company

Company Address

City

State

Zip

Start Date (mo/yr.)

End Date (mo/yr.)

Position Held

Salary/Wage

Reason for leaving

Supervisor or Contact Person

Phone Number

Was your job duties commercially driving related?

Was your job duties DOT-Regulated?

MVR Record

Have you had any accidents in the past 3 years?

Have you had any traffic citations in the past 3 years?

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

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

Select the type of endorsements you have

Education

What is your level of education?

Office Hours

Contact Us

DRIVER'S APPLICATION FOR EMPLOYMENT

List your addresses of residency for the past 3 years

Current Address

Previous Addresses

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 (CMV)* in intrastate or interstate commerce shall also provide an additional 7 years of employment history. (NOTE: List employers in reverse order starting with the most recent employer.)

Additional Employment

Additional Employment

MVR Record

Education

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