Apply for Class A - Semi Truck Owner Operators

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Class A - Semi Truck Owner Operators
ID:150605W
Job Type:Regional, OTR
License Class :Class A CDL
Hiring State:IL
Minimum Experience (months):3 years or more
Trailer Type:Dry Van (V), Reefer (R), Flatbed (F)
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Cell Phone:
* Email:
* Source:
How did you hear about us?
* License Class:
Application Information
* Position Type:
General Driver's Application
PERSONAL INFORMATION
* Date of Birth:
* SSN#:
* Do you Live in the United States?
* Years at Current Residence?
If less than 5 years at current residence please provide prior living address:
Highest Level of Education:

MILITARY SERVICE
* Were you ever in the military?
Yes No
If yes, what branch?
Start Date:
End Date:
Honorable Discharge?
Yes No

LICENSE & DRIVING INFORMATION
* Which Class of License do you possess?
* Drivers License State:
* Drivers License Number:
* Drivers License Expiration Date:
* Physical Expiration Date:
* Endorsements:
* Hold Ctrl/Cmd to select multiple items
* Have you held any additional licenses in the last 3 years?
Yes No
If yes to above question, please provide details:
* Do you possess a valid TWIC?
Yes No
* Do you possess a valid Passport?
Yes No
* Which of the following do you have experience with?
* Hold Ctrl/Cmd to select multiple items

OWNER / OPERATOR INFORMATION
* Are you an owner operator?
Yes No
Number of trucks owned:
Truck Year
Truck Make
Truck Model
Do you own the truck outright?
Yes No
Empty Gross Weight:Wheel Base:
5th Wheel Height:Stack Height:

DRIVER TRAINING SCHOOL
* Have you ever attended a driving school?
Yes No
If yes to the above question, list name of school, dates attended and graduation date.:

EMPLOYMENT INFORMATION
* Have you been employed or attended a Company Orientation over the last 3 years?
Yes No
If yes to above question, with whom?

EMPLOYER 1

Dates Employed Employer Name & Address Employer Phone & Fax
From:
*

To:
*
*

*
*
Job Title Supervisor Name & Title May we Contact?

*
Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
*
Yes No
*
*
Average days out on the road? Number of states driven? Length of trailer hauled?
*
*
*
Reason for leaving? Please Explain: Additional Comments?
*
*

Employer 2

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 3

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 4

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 5

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 6

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 7

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 8

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 9

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 

EMPLOYER 10

Dates Employed Employer Name & Address Employer Phone & Fax
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Did you operate a CMV? Most common vehicle or truck driven? Most common trailer hauled?
Yes No
Average days out on the road? Number of states driven? Length of trailer hauled?
Reason for leaving? Additional Comments?  
 


* Do you have any other employers over the last 3 years?
Yes No
* The DOT requires 10 years of employment history if you have driven a truck for that long. Have you had any additional employers beyond the last 3 years of employment for whom you drove a CMV for?
Yes No
* Have you been unemployed at any time during the last three (3) years for a period greater than ninety (90) days?
Yes No
If yes to above question, please provide dates and reason.
TRAFFIC CONVICTIONS
* Do you have ANY traffic convictions within the last 5 years?
Yes No

TRAFFIC CONVICTION 1

Date of Conviction Type of Vehicle Operating Conviction Type
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 


TRAFFIC CONVICTION 2

Date of Conviction Type of Vehicle Operating Conviction Type
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 


TRAFFIC CONVICTION 3

Date of Conviction Type of Vehicle Operating Conviction Type
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 


TRAFFIC CONVICTION 4

Date of Conviction Type of Vehicle Operating Conviction Type
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 


TRAFFIC CONVICTION 5

Date of Conviction Type of Vehicle Operating Conviction Type
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 


TRAFFIC ACCIDENTS
* Do you have ANY vehicle accidents within the last 5?
Yes No

ACCIDENT 1

Date of Accident Accident Type What vehicle type were you operating?
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 

Was this accident DOT recordable?
Yes No
Was this accident preventable?
Yes No


ACCIDENT 2

Date of Accident Accident Type What vehicle type were you operating?
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 

Was this accident DOT recordable?
Yes No
Was this accident preventable?
Yes No


ACCIDENT 3

Date of Accident Accident Type What vehicle type were you operating?
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 

Was this accident DOT recordable?
Yes No
Was this accident preventable?
Yes No


ACCIDENT 4

Date of Accident Accident Type What vehicle type were you operating?
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 

Was this accident DOT recordable?
Yes No
Was this accident preventable?
Yes No


ACCIDENT 5

Date of Accident Accident Type What vehicle type were you operating?
Personally Operated Vehicle (POV)
Commercial Motor Vehicle (CMV)
Additional Explanation: Supporting Documents  
 

Was this accident DOT recordable?
Yes No
Was this accident preventable?
Yes No


BACKGROUND HISTORY
* Have you ever been convicted of a felony or a misdemeanor which resulted in imprisonment within the last seven years? (A conviction will not necessarily result in the denial of employment) If you reside in MN, RI, MA, HI please click NA:
Yes No NA
If yes to the above question please explain.
* Have you ever had a drug conviction?
Yes No
If yes to the above question please explain.
* Have you ever been charged with DUI/DWI?
Yes No
If yes to the above question please explain.
* Have you ever had your license suspended and or revoked?
Yes No
If yes to the above question please explain.
* Have you ever been denied a license?
Yes No
If yes to the above question please explain.
* Have you ever been charged with Reckless Driving or Driving to Endanger?
Yes No
If yes to the above question please explain.
* Have you ever tested positive on a pre-employment drug screen or a random drug screen?
Yes No
If yes to the above question please explain.

AUTHORIZATION AND RELEASE
I confirm that the information submitted via this 'Driver's Application' is true and correct to the best of my knowledge.

* Signature (type name):
* Date:

Please enter the last four digits of your Social Security number to confirm your submission:
*

Prefered Schedule
* How many weeks would you stay OTR ?:
Home every weekend
2 weeks out
3 weeks out
4 or more weeks out
CDL
* Please upload a clear, color copy of your CDL.:
Please upload a copy of your medical card, if available.:

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