Give a COMPLETE RECORD of all employment for the past 10 years, including any unemployment or self-employment. DO NOT leave gaps in employment dates. DO NOT use N/A, you must list or say NONE.
To Be Read And Signed By Applicant
It is agreed and understood that any misrepresentation given above shall be considered an act of dishonesty.
It is agreed and understood that the motor carrier or his agents may investigate the applicant’s background to ascertain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and persons named herein from all liability or any damages on account of his furnishing such information.
It is also agreed and understood that under the Fair Credit Report Act, Public Law 91-508, I have been told this investigation may include an Investigation Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.
I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.
It is agreed and understood that this application for qualification in no way obligates the company to employ the applicant.
It is agreed and understood that if qualified, the driver may be on a probationary period during which time he/she may be disqualified without recourse.
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.