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CDL DRIVER APPLICATION FORM

(The Age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age)
Current & Previous Three Years Addresses

DRIVING EXPERIENCE

Class of Equipment
From
To
Approximate Number of Miles
Straight Truck
Tractor & Semitrailer
Tractor & two trailers
Tractor & triple trailers
Other

Job References

List three (3) persons for references, other than family members, who have knowledge of your safety habits.

List last 5 years of employment - starting with current

Dates Worked From

Dates Worked From

Dates Worked From

Dates Worked From

Dates Worked From