Oddson Underground

Serving all your underground utilities needs

Job Application: Oddson Underground Commercial Driver License

Title: Oddson Underground Commercial Driver License

Fields marked with an asterisk (*) must be filled out before submitting.

Personal Details

Name *
Email Address *

Contact Details

Address *
City *
State & Zip Code
Post code *
How Long? *
Date of Birth *
Social Security No.
Cell phone
Telephone *
Emergency Contact Information

Previous Three Years Residency

Residency #1 Street
City
State & Zip Code
Number of years
Residency #2 (if applicable) Street
City
State & Zip Code
Number of years
Residency #3 (if applicable) Street
City
State & Zip Code
Number of years

License Information

State licensed to
License number
Type
Expiration Date

Driving Experience- Straight Truck (if applicable)

Class of equipment
Type of equipment (van, tank, flat, etc.)
Dates from & to
Approx. number of total miles

Driving Experience- Tractor and Semi Trailer (if applicable)

Class of Equipment
Type of equipment (van, tank, flat, etc.)
Dates from and to
Approx. number of total miles
Type of equipment (van, tank, flat, etc.)

Driving Experience- Tractor, Two Trailers (if applicable)

Class of Equipment
Dates from and to
Approx. number of total miles

Other:

Class of equipment
Type of equipment (van, tank, flat, etc.)
Approx. number of total miles
Dates from and to

Accident record for past three years (attach sheet if more space is needed)

Dates
Nature of accident (head-on, rear-end, upset, etc.)
Number of fatalities
Number of injuries
Chemical Spills?
Upload your sheet with additional info

Traffic convictions and forfeitures for the past three years (other than parking violations)

Date Convicted (month/year)
Violation
State of violation location
Penalty (forfeited bond, collateral and/or points)
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Has any license, permit or privilege ever been suspended or revoked?
If yes, explain

**Please note that we will be running your drivers license prior to hiring to verify you have a valid drivers license and a clean driving record**

Education

Name of High School and College and Graduation dates

Employment Record- must list the complete mailing address, street number and name, city state and zip code

Last Employer, Name
Address
Phone
Position Held
From
To
Salary
Reasons for Leaving
Any gaps in employment and/or unemployment must be explained. Include dates (month/year) and reason.
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements by 49 CFR Part 40?
Second Last Employer, Name
Address
Phone
Position Held
From
To
Salary
Reasons for Leaving
Any gaps in employment and/or unemployment must be explained. Include dates (month/year) and reason.
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements by 49 CFR Part 40?
Third Last Employer, Name
Address
Phone
Position Held
From
To
Salary
Reasons for Leaving
Any gaps in employment and/or unemployment must be explained. Include dates (month/year) and reason.
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements by 49 CFR Part 40?

Please note that Oddson Underground, Inc, reserves the right to contact previous employers to verify past employment

By submitting this I authorize you to make sure investigations and inquiries to my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to: Review information provided by current/previous employers, Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer, and Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

 
Oddson Underground © 2016 Frontier Theme