Company Driver Application
 

1. Driver Information

 
R.L. Carter Trucking, Inc.
8451 S. State Road 39
Clayton, IN 46118

Phone: 317.539.4364 or 1.800.531.7124
Fax: 866.560.3446

In Compliance with Federal and State equal opportunity laws, qualified applicants are considered for all positions without regard to race, religion, sex, national origin, age, marital status, or non-job related disability.

I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e).

I also understand that I have the right to:
* Review information provided by previous employers
* Have Errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer, and
* Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

Driver Name (Last),(First),(Middle):

Date of Birth

 MonthDayYear
D.O.B:

Social Security Number (no dashes or spaces):

Address

**EMERGENCY CONTACT**

Email Address:

**GENERAL**

 YES:NO:
Have you ever been convicted for DUI, DWI or OUI?:
Is there any reason you might be unable to perform the functions of the job for which you have applied?:
Have you been a driver for this company before?:

**EDUCATION**

 Elementary/HSCollege
Please select the highest grade completed:

Have you received any safety awards or special training?:

Do you have full knowledge of the Federal Motor Carrier Safety Regulations?

Previous Addresses for the Past Three(3) Years(if applicable).

 25% 
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