Driver Application for Quality Haulers

QH Driver Application

Please provide as much information as possible in order for Quality Haulers to accurately consider your application. If you are unable to complete the required information in this form, you may send your resume to [email protected]

QUALITY HAULERS DRIVER APPLICATION

First Name *

Last Name *

Phone # *

Email *

Preferred Method of Contact *

What is the best time for us to reach you?

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Social Security # *

Date of Birth *

The US Dept. of Transportation requires that the driver applicants state their date of birth. {49 CFR Part 391.21 (b) (2)}

Are you age 21 or older? *

What brings you to Quality Haulers? *

Who referred you?

How did you hear about us? *

Resume Upload

Drop your file here or click here to upload

Were you subject to the Federal Motor Carrier Safety Regulations while employed by a previous employer? *

Was past employment job designated as a safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing requirements as required by 49 CFR – Part 40? *

LICENSES

State *

Class *

Driver applicant must have Class A or Class B CDL to be employed with Quality Haulers.

Accidents

Have you been involved in any work-related accidents in the last three years? *

If you answer “Yes”, please enter accident details below.

Date of Accident *

(For Example: Over-corrected, Head-on, Rear-end, Blow-out, etc.)

Please briefly describe what happened… *

Have you had another work-related accident in the last three years? *

If answer is “Yes”, please fill out additional accident information.

Date of Accident #2 *

(For Example: Over-corrected, Head-on, Rear-end, Blow-out, etc.)

Please briefly describe what happened in your second accident… *

Have you had a third work-related accident in the last three years? *

If answer is “Yes”, please fill out additional accident information.

Date of Accident #3 *

(For Example: Over-corrected, Head-on, Rear-end, Blow-out, etc.)

Please briefly describe what happened in your third accident… *

Traffic Convictions & Forfeitures

Other than parking violations, have you had any traffic convictions or forfeitures in the last three years? *

If you answer “Yes”, please add required information below.

Traffic Conviction/Forfeiture #1

Date of Conviction/Forfeiture #1 *

Location of Conviction/Forfeiture #1 *

Please provide as much information as possible. Address/City/State/Zip.

What were you charged with? *

Please provide as much information as possible.

Have you had another Conviction/Forfeiture in the last three years? *

If you answered “Yes”, then please provide details below.

Traffic Conviction/Forfeiture #2

Location of Conviction/Forfeiture #2 *

Please provide as much information as possible. Address/City/State/Zip.

What were you charged with in Conviction/Forfeiture #2 *

Please provide as much information as possible.

Have you had a third Conviction/Forfeiture in the last three years? *

If you answered “Yes”, then please provide details below.

WORK HISTORY | MVR

Are you currently employed? *

If you answered “Yes”, please fill out detailed information below.

Current Employer Information

Company Name *

Supervisor’s Name (First & Last) *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Company Phone#

What is your position at this company?

Date of Hire

Current Salary *

Please briefly tell us why you want to leave your current job… *

Are you currently employed with another company? *

If you answer “Yes”, please provide the information of your second employer below.

Current Employer #2

Company Name *

Supervisor’s Name *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Company Phone#

What is your position at this company?

Date of Hire

Current Salary *

Please briefly tell us why you want to leave your current job… *

Are you currently employed with a third company? *

If you answer “Yes”, please provide the information of your second employer below.

Current Employer #3

Company Name *

Supervisor’s Name *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Company Phone#

What is your position at this company?

Date of Hire

Current Salary *

Please briefly tell us why you want to leave your current job… *

The U.S. Department of Transportation requires that driver applications show all employment for the past three years. They must also show any commercial driver employment for the seven years immediately preceding this three year period. §391.21 (B) (10), (11)

Would you like to: *

Upload your MVR.
Upload work history via Resume or other digital file.
Manually input work history.

If you do not have an MVR, Resume, or other digital file with your work history available, please manually input previous work history for the last 3 years, and any commercial driver employment for the 7 years immediately preceding this 3 year period.

Please upload your 10 year MVR here. *

Drop your file here or click here to upload

You will hear from us sooner if you upload your MVR.

If you did not previously upload a resume showing your work history, and do not have a copy of your MVR, please provide your work history in a file here. *

Drop your file here or click here to upload

WORK HISTORY

Previous Employer #1

Company #1 Name *

Supervisor’s Name *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Company Phone#

What is was your position at this company? *

Date of Hire *

If you do not know the exact day, please default to the 1st of the month in the year you were hired.

What was your salary or hourly pay? *

Please briefly describe why you left this company… *

Add previous employer #2?

Previous Employer #2

Company #2 Name *

Supervisor’s Name *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Company Phone#

What is was your position at this company? *

Date of Hire *

If you do not know the exact day, please default to the 1st of the month in the year you were hired.

What was your salary or hourly pay? *

Please briefly describe why you left this company… *

Add previous employer #3? *

Previous Employer #3

Company #3 Name *

Supervisor’s Name *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Company Phone#

What is was your position at this company? *

Date of Hire *

If you do not know the exact day, please default to the 1st of the month in the year you were hired.

What was your salary or hourly pay? *

Please briefly describe why you left this company… *

Add previous employer #4?

Previous Employer #4

Company #4 Name *

Supervisor’s Name *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

What is was your position at this company? *

Company Phone#

Date of Hire *

If you do not know the exact day, please default to the 1st of the month in the year you were hired.

What was your salary or hourly pay? *

Please briefly describe why you left this company… *

Add previous employer #5?

Previous Employer #5

Company #5 Name *

Supervisor’s Name *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

What is was your position at this company? *

Company Phone#

Date of Hire *

If you do not know the exact day, please default to the 1st of the month in the year you were hired.

What was your salary or hourly pay? *

Please briefly describe why you left this company… *

Add previous employer #6?

Phone

QH Driver Application

QUALITY HAULERS DRIVER APPLICATION

LICENSES

Driving Experience

Accidents

Traffic Convictions & Forfeitures

Traffic Conviction/Forfeiture #1

Traffic Conviction/Forfeiture #2

WORK HISTORY | MVR

Current Employer Information

Current Employer #2

Current Employer #3

The U.S. Department of Transportation requires that driver applications show all employment for the past three years. They must also show any commercial driver employment for the seven years immediately preceding this three year period. §391.21 (B) (10), (11)

WORK HISTORY

Previous Employer #1

Previous Employer #2

Previous Employer #3

Previous Employer #4

Previous Employer #5