APPLICATION FOR EMPLOYMENT

FOR DRIVER POSITIONS

Step 1 of 10

PERSONAL INFORMATION
FIRST NAME*
MIDDLE NAME
LAST NAME*
PHONE*
PERSONAL EMAIL*
DATE OF BIRTH*
MM slash DD slash YYYY
DO YOU HAVE THE LEGAL RIGHT TO WORK IN THE UNITED STATES?*
- Yes
- No

PREVIOUS 3 YEAR RESIDENCY
CURRENT*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
# OF YEARS AT THIS ADDRESS*
Please enter a number from 0 to 100.
PREVIOUS
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
# OF YEARS AT THIS ADDRESS
Please enter a number from 0 to 100.
PREVIOUS
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
# OF YEARS AT THIS ADDRESS
Please enter a number from 0 to 100.

DRIVING EXPERIENCE
CLASS OF EQUIPMENT*
- STRAIGHT TRUCK
- TRACTOR & SEMI-TRAILER
- TRACTOR & 2 TRAILERS
- TRACTOR & TANKER
- OTHER
TYPE OF EQUIPMENT PULLED WITH STRAIGHT TRUCK (VAN, TANK, FLAT, ETC.)*
TYPE OF EQUIPMENT PULLED WITH TRACTOR AND SEMI-TRAILER (VAN, TANK, FLAT, ETC.)*
TYPE OF EQUIPMENT PULLED WITH TRACTOR AND 2 TRAILERS (VAN, TANK, FLAT, ETC.)*
TYPE OF EQUIPMENT PULLED WITH TRACTOR AND 2 TANKER (VAN, TANK, FLAT, ETC.)*
TYPE OF EQUIPMENT PULLED WITH OTHER (VAN, TANK, FLAT, ETC.)*
STRAIGHT TRUCK – DATE FROM*
MM slash DD slash YYYY
STRAIGHT TRUCK – DATE TO*
MM slash DD slash YYYY
APPROX # OF MILES (TOTAL)*
TRACTOR AND SEMI-TRAILER – DATE FROM*
MM slash DD slash YYYY
TRACTOR AND SEMI-TRAILER – DATE TO*
MM slash DD slash YYYY
APPROX # OF MILES (TOTAL)*
TRACTOR AND 2 TRAILERS – DATE FROM*
MM slash DD slash YYYY
TRACTOR AND 2 TRAILERS – DATE TO*
MM slash DD slash YYYY
APPROX # OF MILES (TOTAL)*
TRACTOR AND TANKER – DATE FROM*
MM slash DD slash YYYY
TRACTOR AND TANKER – DATE TO*
MM slash DD slash YYYY
APPROX # OF MILES (TOTAL)*
OTHER – DATE FROM*
MM slash DD slash YYYY
OTHER – DATE TO*
MM slash DD slash YYYY
APPROX # OF MILES (TOTAL)*

AUTHORIZATION
I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company. I understand that the information I provide regarding my current and/or prior 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. I understand that I have the right to: •Review information provided by current/previous employers; •Have errors in the information corrected by previous employers, and for those previous employers to resend thecorrected information to the prospective employer; and •Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannotagree on the accuracy of the information. This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.

Diamond C Trailers is an Equal Opportunity employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.

I HAVE READ, UNDERSTAND AND AGREE TO THIS STATEMENT.
PLEASE SELECT*
- I agree
- I disagree