Employment Application - ABERDEEN EXPRESS, Cincinnati, OH

Driver Application for Employment
First Name:	MI Last Name
Social Security Number	- -
Drivers License Number
Birth Date
Address
City	State Zip
Phone.	- -
E-Mail
Date Available
Are you an owner operator?
Total years of CDL-A driving experience?
Years of van/reefer experience?
How many chargeable accidents in last 3 yrs?
How many moving violations in last 3 yrs?
License ever suspended?
Reckless driving in last 7 yrs?
Felony Convictions?
DUI Charges?
Hazmat Certified?
Months CDL-A driving in last three yrs?
Number of jobs in last 3 yrs?

Current/Most Recent Employer
Phone	- -
Are you presently Employed?
May we call your current employer?
Address
Position Held
From Date:
To Date:
Why do you want to change employers?

Second Last Employer
Phone	- -
Address
Position Held
From Date:
To Date:
Why did you quit?

Third Last Employer
Phone	- -
Address
Position Held
From Date:
To Date:
Why did you quit?
I certify that I personally completed this application and that all of the information is true and correct. I authorize Aberdeen Express to conduct a thorough background investigation in accordance with state and federal law and authorize my previous employers to release any information requested by Aberdeen Express and hold them harmless of all liability from the release of said information. Also, in accordance with the provisions of 49 CFR Part 382.405 and 382.413, I hereby authorize and require my previous and/or current employers specifically listed by me on this application to release the results (including any refusal to test) of all drug and alcohol tests taken by me pursuant to the provisions of 49 CFR while in their employment to Aberdeen Express. by whatever means is most expedient. I Agree: