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Office Applicant Form

Available Loads Employment

Dedicated Drivers and Staff

Freight distribution and transportation

Current Fuel Surcharge$0.3096

Office Applicant Form

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Please select position you are applying for.
Name
First Middle Last
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If necessary, best time to call you at home is:
May we contact you at work?
- Yes
- No
Work number:
Best time to call:
Have you filed an application here before?
- Yes
- No
When?
MM slash DD slash YYYY
Are you legally eligible for employment in this country?
- Yes
- No
(Proof of U.S. citizenship or immigration status will be required upon employment.)
Date available for work
MM slash DD slash YYYY
Type of employment desired
- Full Time
- Part-Time
- Temporary
- Seasonal
- Educational Co-Op
Are you on a lay-off and subject to recall?
- Yes
- No
Will you relocate if the job requires it?
- Yes
- No
Will you work overtime if required?
- Yes
- No
As a condition of employment you will be required to undergo a pre-employment physical and substance abuse screening. Do you consent?
- Yes
- No
Driver's License No.
State

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Position applied for:
Have you worked for this company before?
- Yes
- No
Where?
Dates:
Rate of pay:
Position:
Reason for leaving:
Referral Source:
- Advertisement
- Employee
- Relative
- Government Employment Agency
- Walk-in
- Private Employment Agency
- Other
Who do you know at this company?

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EMERGENCY CONTACT
IN CASE OF EMERGENCY NOTIFY:
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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PAST 10 YEARS EMPLOYMENT
Last Employer (please list most recent first):
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position held and rate of pay:
Dates job started and ended:
Reason for leaving
Next Employer's name:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position held and rate of pay:
Dates job started and ended:
Reason for leaving
Next Employer's name:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position held and rate of pay:
Job Duties:
Dates job started and ended:
Reason for leaving
Attach a Resume
Accepted file types: doc, docx, Max. file size: 5 MB.
Upload a word document of the rest of your employment history for the past 10 years. 5MB limit.

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Have you served in the armed forces?
- Yes
- No
EDUCATION
Select highest grade completed
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- High School: 1
- High School: 2
- High School: 3
- High School: 4
- College: 1
- College: 2
- College: 3
- College: 4
Last school attended:
Name and city

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LIST BELOW THREE CHARACTER REFERENCES, NOT RELATIVES OR EMPLOYERS
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Business
Phone
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Business
Phone
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Business
Phone

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EXPERIENCE AND QUALIFICATIONS – PLATFORM
List types of platform experience and years of each (if applicable):
List platform equipment you can operate (Lift, Truck, etc.) (if applicable):
Show courses or training in platform work (if applicable):
EXPERIENCE AND QUALIFICATIONS – MAINTENANCE
List types of maintenance experience and years of each (if applicable):
What equipment can you operate?
- Woodworking Equipment
- Sheet Metal Equipment
- Clutch Rebuilding
- Differential Rebuilding
- Transmission Rebuilding
- Body Work
- Frame & Axle Straightening Equipment
- Electrical & Ignition Repair
- Engine Rebuilding Equipment
- Diesel Injection Equipment
- Electric Welder
- Oxyacetylene Welder
- Paint Spray Gun
- Wheel & Tire Balancing Machine
- Tire Recapping Mold
- Engine Dynamometer
- Chassis Dynamometer
- Magnetic Crack Tester
- Vacuum & Air Braker
- Other
Please list years of experience and any other information related to the equipment you selected above:
List courses and training in maintenance work:

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EXPERIENCE AND QUALIFICATIONS – CLERICAL
Indicate training and experience in the following:
- Typing*
- Data Entry
- Billing
- TWX
- PBX
- Key Punch Operator
- Calculator
- Shorthand
- Dictating Machine Transcriber
- Personal Computer
- Rates**
- OS & D
- Interline
- Claims
- Cashier
- Accounting
- Dispatcher
- Gate Inspector
- Other
*indicate words per minute **Indicate tariffs with which you have worked
Please list years of experience and any other information related to the qualifications you checked above:
List courses and training for office work:

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Show any trucking, transportation or other experience that may help in your work for this company (if applicable):
List courses and training other than show elsewhere in this application (if applicable):
List special equipment or technical materials you can work with (other than those already shown) (if applicable):

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TO BE READ AND SIGNED BY THE APPLICANT
Answer ALL applicable questions on this application. Incomplete applications will be discarded. I understand that any incorrect, incomplete or false statement or information furnished by me will subject me to discharge. In the event that I am employed, I agree to comply with all of the employer's orders, rules and regulations. I hereby authorize my former employers to provide any and all information regarding my employment and any other interaction with them. I understand that I may be asked to demonstrate that I am capable of performing tasks associated with the position applied for. I agree and understand that my background may be investigated for any and all information of concern to my record and I hereby release the employer and their representatives from all liability for damages resulting from the collection and use of such information. I agree and understand that this application for employment in no way obligates the employer to employ me. Public Law 91-506 requires that an applicant be advised that a routine inquiry may be made which will provide valid information concerning character, general reputation, personal characteristics and mode of living. Upon written request, additional information as to nature and scope of the report if one is made will be provided. Where relevant, information in this application will be used and prior employers will be contacted for purposes of investigation as required by 391-23 of the Motor Carrier Safety Regulation.
Date*
MM slash DD slash YYYY
Applicant's Signature*

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Contact Us

30 Lau Parkway, Clayton, OH 45315
Call: (937) 832-9350
Fax: (937)-832-9243

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