DriverShopApplication

Personal Data (1 of 13)

Application Date
Type of work desired
Full Name - First	Last Middle
Social Security No
Date of Birth	(d/m/yyyy)
Home Phone
Message Phone
Emergency Contact
Relationship
Emergency Phone

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Address Information (2 of 13)
Please enter your address information for the past 5 years.
Current Address	Street Years City State Zip
Previous Address 1	Street Years City State Zip
Previous Address 2	Street Years City State Zip
Additional Address Info
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Eligiblity Questions (3 of 13)
Are you over 23 years old? Yes No Are you eligible for Employment in the US? Yes No List any relative working for Howl Transportation Name Location Relationship Have you ever worked for Howl before? Yes No If Yes, When Where Who referred you?
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Miscellaneous Questions (4 of 13)
Do you have reliable transportation to work? Yes No Would you be willing to relocate? Yes No Are you aware that you may work irregular hours or days, including weekends? Yes No Will you accept company recommended medical facilities for work related injuries? Yes No Can you meet attendance requirements? Yes No Have you ever been discharged or suspended from any job? Yes No If yes, please explain when and why. Can you enter the country of Canada? Yes No If no, explain why.
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Education (5 of 13)
Select highest grade completed Last School Attended (name and address) Did you receive a degree? Yes No If yes, what degree and course of study? Professional Truck Driving school attended (name and location) Graduation Date
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Employment (6 of 13)
List your employers for the last 10 years including all full and part time employment. All time must be accounted for including military service, self-employment and periods of unemployment. You must submit employer's phone number. Are you currently Employed? Yes No If no, how long have you been unemployed? May we contact your current employer? Yes No Current Employer Name Supervisor Address Phone Position Held From To Rate Of Pay # Of States Driven In # Of Accidents Reason for changing employers Second Last Employer Name Supervisor Address Phone Position Held From To Rate Of Pay # Of States Driven In # Of Accidents Reason for Leaving Third Last Employer Name Supervisor Address Phone Position Held From To Rate Of Pay # Of States Driven In # Of Accidents Reason for Leaving Fourth Last Employer Name Supervisor Address Phone Position Held From To Rate Of Pay # Of States Driven In # Of Accidents Reason for Leaving Fifth Last Employer Name Supervisor Address Phone Position Held From To Rate Of Pay # Of States Driven In # Of Accidents Reason for Leaving Additional Employment Info
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Safety Record (7 of 13)

List all accidents with a commercial or private vehicle including property damage for the past 5 years,
including preventable and non preventable accidents. (If no accidents, enter 0 below)

Total number of accidents in past five years

Preventable	Fatalities	Injuries
Yes No	Yes No	Yes No
Yes No	Yes No	Yes No
Yes No	Yes No	Yes No
Yes No	Yes No	Yes No
Yes No	Yes No	Yes No

Additional Accident Info

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Safety Questions (8 of 13)
Have you ever been denied a license, permit, or privilege to operate a motor vehicle? Yes No Has your license, permit or privilege to operate a motor vehicle ever been suspended or revoked? Yes No Have you ever been convicted of operating a motor vehicle while under the influence of alcohol and/or illegal drugs? Yes No With the exception of traffic violations, have you ever been convicted by law enforcement authority for violation of any Federal, State, Parish, County or Municipal law? Yes No Have you ever been convicted for possession, sale or use of a narcotic drug, amphetamines or a derivative thereof? Yes No Have you ever been convicted of a felony? Yes No If you answered yes to any of the above questions, please explain.
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License Information (9 of 13)

Total Years of Driving Experience

Drivers Licenses held in the last three years must be shown.

State	License No	Class	Endorsement(s)	Expiration Date

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Violations of Motor Vehicle Law (10 of 13)

List all violations of Motor Vehicle Law (other than parking) of which you were convicted
or forfeited bond during the past three (3) years. (If no violations, enter 0 below)

Total number of violations in past three years

Date	Offense	Location	Vehicle Type

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Medical History (DOT Standard) (11 of 13)
Are you able to meet the medical requirements of FMCSR 391 (Subpart E)? Yes No Are you taking any type of medication listed under FMCSR Part 40 or address IAW FMCSR 382.213? Yes No Misc Questions What is your CB Name What is your shirt size
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Shop Applicants Only (12 of 13)

Engines

Type	Make	Model	Years Exp

Differentials

Type	Make	Years Exp

Transmissions

Type	Make	Years Exp

Indicate your years of experience in the following areas:

List Years of Experience In
Lubrication
Relining Brakes
Painting
Welding
Sheet Metal Work
Trailer Bearings
Rebuilding Tractors/Trailers

Briefly outline other shop experience not listed above,
including nature of work and years of experience

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Acknowledgement, Release and Final Signature (13 of 13)
JOB DESCRIPTION: Driver, age requirement: 23 years of age LICENSE REQUIRED: CDL Class A License / Commercial Drivers License EXPERIENCE REQUIREMENTS: Six months verifiable over the road experience in a class 8 vehicle; or graduated form a company approved driving school; or willing to be placed with a Driver Trainer. JOB DUTIES: 1. Run team operations. 2. Perform all actions safely including but not limited to, driving a tractor-trailer or trailers. 3. Responsible for dropping, hooking and pulling a 5th wheel pin. 4. Responsible for loading, unloading, or tarping and securing, when required. 5. Safe operation of the equipment by Company policy and FMCSR regulations. CANDIDATE WILL BE DISQUALIFIED IF: 1. The driver cannot meet or exceed all phyisical requirements under FMCSR 391 (Subpart E) and company regulations. 2. The driver cannot meet essential physical functions requiring hours of: sitting, standing, bending, crouching, kneeling, climbing and lifting up to 80 lbs. from ground level to above the head. 3. The driver cannot meet mental requirements of simple arithmetic, measuring, reading, writing, understanding and using acceptable English, following directions verbally, map reading, and ability to operate in-cab computer. 4. The driver cannot work in a trucking enviroment that requires working day or night, holidays, in any climate condition, or work in an enviroment of dust, dirt, fuel and chemical vapors, noise and driving all types of roads. 5. The dirver cannot demonstrate employment reliability, honesty, cooperation, communication skills, dependability and be a team player. 6. The driver has an unacceptable work or accident history. 7. The driver cannot be reached by phone. 8. The driver cannot conform to dress code. Acknowledgment AND Release I understand that nothing contained in this employment application or in any oral representations made to me in the interview process may create an employment contract - express or implied - between Howl Transportation and myself. I understand and acknowledge that if hired, my employment status will be that of an employee at will; that is, I am employed for no specific duration of time and my employment may be terminated without cause and without notice at any time by either me or the Company. No individual, other than the President of Howl Transportation, has the authority to enter into a contract of employment with me for any specific duration of time or in any way modifying the at-will nature of my employment, and any such contract must be in writing and signed by the President and myself. I also understand that all statements made are open to investigation by Howl Transportion and that if any information given by me in this application is found to be false or misleading, regardless of when discovered, I will be subject to dismissal at any time and I agree to hold Howl Transportion blameless in that event. I affirm that everything herein is true and correct. I hereby authorize Howl Transportation, its officers and agents, to investigate and compile a complete history of my former employment together with any and all information concerning my ability, character, criminal conviction record, etc. I release Howl Transportation, its officers and agents, from any and all liability whatsoever in the gathering and use of this information concerning me. I further release previous employers, schools, physicians, and any state or federal agency from all liability for furnishing information concerning me to Howl Transportation.
Signature (type your full name) Date
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Driver / Shop Application