Please enable JavaScript in your browser to complete this form. - Step 1 of 4Contact InformationName *FirstMiddleLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhen did you start living here? *Click on year box to changeHave you lived at this address less than 7 years? *YesNoPrevious Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhen did you start living here? *Click on year box to changePhone Number *Email *EmailConfirm EmailSocial Security Number *Date of Birth *Click on year box to changeThe minimum age to become a driver is 21. Do you qualify? *YesNoAre you able to present evidence of your legal right to work in the U.S.? *YesNoWhat type of work schedule are you interested in? *Full-timePart-timeUndecidedWhen are you able to work?DaysNightsWeekendsAnytimeDo you have previous military experience? *YesNoNextDriving HistoryDo you hold a valid Driver's License? *YesNoWhich type of drivers license do you currently have? *OperatorChauffeurCDL-ACDL-BCDL-CIf you currently have a Commercial Drivers License (CDL), which valid endorsements do you have?Air BrakesP - passengerS - school busT - double/triplesN - tankerH - hazmatX - tanker/hazmat comboIn which State do you hold a valid driver's license? *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelewareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS Virgin IslandsPuerto RicoOtherEnter you driver's license number: *Expiration date: *Click on year box to changeDo you have a minimum of three (3) years of licensed driving experience? *YesNoHave you ever been denied a license, permit or privilege to operate a motor vehicle? *YesNoIf you answered 'Yes' to the above question, please provide details below:Has any license, permit or privilege ever been suspended or revoked? *YesNoIf you answered 'Yes' to the above question, please provide details below:Have you ever been disqualified subject to Part 391 of the Federal Motor Carrier Safety Regulation? *YesNoIf you answered 'Yes' to the above question, please provide details below:Have you in the past three (3) years failed or refused a DOT-mandated drug/alcohol test(s)? *YesNoIf you answered 'Yes' to the above question, please provide details below:Have you had any accidents during the last three (3) years? *YesNoIf you answered 'Yes' to the above question, please provide details below:Have you had any traffic citations, traffic convictions and/or forfeitures during the past 3 years (other than parking violations)? *YesNoIf you answered 'Yes' to the above question, please provide details below:Have you had any impaired driving convictions - Driving Under the Influence (DUI) or Driving While Intoxicated (DWI)? *YesNoIf you answered 'Yes' to the above question, please provide details below:PreviousNextWork HistoryHave you ever been fired or asked to resign by an employer? *YesNoHave you ever applied to work for Drivergent, Inc. before? *YesNoHave you ever worked for Drivergent, Inc. before? *YesNoAre you currently employed? *YesNoCurrent or Last Employer Name *Employer Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeStart Date *Click on year box to changeEnd Date *Use today's date if still employedEmployer Phone *Employer EmailEmployer Website / URLWhat was your last position held with this employer? *Briefly describe your job duties & responsibilities *Was this a driving position? *YesNoWas this position subject to FMCSA or DOT regulations? *YesNoReason for leaving this employer? *Were you employed here for less than 5 years? *YesNoPrevious Employer Name *Previous Employer Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeStart Date *Click on year box to changeEnd Date *Use today's date if still employedPrevious Employer Phone *Previous Employer EmailPrevious Employer Website / URLWhat was your last position held with this employer? *Briefly describe your job duties & responsibilities *Was this a driving position? *YesNoWas this position subject to FMCSA or DOT regulations? *YesNoReason for leaving this employer? *PreviousNextYou may upload your resume or other application documents for review Drag & Drop Files, Choose Files to Upload You can upload up to 5 files. How did you hear about this job? *Career BuilderCommunity EventCraigslistEmployee ReferralFacebookGoogle Ads / Online AdsIndeedInternet Search EngineJob BankJob FairLinkedInMonster.comMovie TheaterNewspaperOther Internet Job SitePhone Book / Yellow PagesRadioSecretary of State (SOS) adsSigns / Banners / BillboardsOther Social MediaOur VehiclesTVTwitterZip RecruiterPlease enter name of referring employee, if applicable:Data Collection Consent *I consent to having "Drivergent.com" collect my name, email, phone number and personal information!This form collects your name, email, phone number and other personal information so that we can correspond with you in regard to possible employment. Check out our privacy policy for the full story on how we protect and manage your submitted data!Certification of Accuracy *I certify that all statements made on this Application for Employment and in any subsequently executed application or employment documents are true and correct.I understand that any material falsifications or omissions made on this application, or on any pre-employment document, may result in termination of my candidacy or any subsequent employment. If an employee relationship is established, I understand that such employment is terminable at will at any time, for any reason with or without cause, and with or without notice. I also understand that any period of employment is not for any specific duration. In addition, I understand that no one is authorized to make oral exceptions to this policy, and written exceptions are permitted only when they are signed by the President of Drivergent, Inc. (the Company) or his or her designee. I authorize the Company and its representatives to conduct background evaluations and obtain information including but not limited to, criminal history checks from federal, state or local authorities, the Department of Transportation (DOT) and/or the Federal Transportation Administration (FTA). I hereby expressly authorize such inquiries and fully release and discharge the Company and consumer reporting agency, their respective affiliates, subsidiaries, directors, officers, employers, agents and attorneys thereof, and each of them, and any individual, organization, entity, agency, or other source providing information to a consumer reporting agency from all claims and damages arising out of or relating to any investigation of my background for employment purposes. This release is valid for all federal, state, county and local agencies, authorities, previous employers, military services and educational institutions. I acknowledge that any offer of employment is conditioned upon my taking an employment substance abuse test(s) and the Company's receipt of satisfactory results of such a test(s) and receipt of satisfactory background checks and, if necessary to determine ability to perform essential duties of the position offered, the satisfactory results of physical examination. 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. Under section 391.23 (i)(1) (i, ii, iii) of the FMCSR, drivers are entitled to: (i) The right to review information provided by previous employers; (ii) The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer; (iii) The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information. Note: This Application for Employment will be considered active for 90 calendar days.NameSubmit