Driver’s Application for Employment Home » Driver’s Application for Employment Applicant information: Name: Address: Date of Birth: Social Security Number: Cell phone: Email: Previous addresses: (If at the above address for less than three years) Address: Address: Experience and Qualifications-DriverDriver Licenses State: License No.: Type and Endorsements: Expiration Date: Traffic convictions (other than parking violations) and forfeitures for the past three years Location: Date: Charge: Penalty: Location: Date: Charge: Penalty: Location: Date: Charge: Penalty: Background Have you ever been convicted of a felony: Driving History At what age were you issued your first Driver’s License?: Have you ever been denied a license, permit or privilege to operate a motor vehicle?: Has any license, permit or privilege ever been suspended, revoked or denied?: Is there any reason; medical or other that would prevent you from operating a motor vehicle in accordance with all state and federal transportation regulations?: Employment RecordYou are required to give all employment information for at least three years. Last employer Name: Address: Supervisor: Contact Number: Position Held: Date: Salary: Reason for Leaving: Was this employer subject to Federal (or PUC) Motor Carrier Safety Regulations?: Were you subject to controlled substance & alcohol testing under 49 CFR Parts 40/382 while employed here?: Employer Name: Address: Supervisor: Contact Number: Position Held: Date: Salary: Reason for Leaving: Was this employer subject to Federal (or PUC) Motor Carrier Safety Regulations?: Were you subject to controlled substance & alcohol testing under 49 CFR Parts 40/382 while employed here?: Employer Name: Address: Supervisor: Contact Number: Position Held: Date: Salary: Reason for Leaving: Was this employer subject to Federal (or PUC) Motor Carrier Safety Regulations?: Were you subject to controlled substance & alcohol testing under 49 CFR Parts 40/382 while employed here?: