Driver's Application for Employment - Spring Creek Carriers Inc.

Date of Application
MM slash DD slash YYYY
Status:
- Company Driver
- Owner Operator
Last Name:*
First Name:*
Middle Name:
List your addresses of residency for the past 3 years:
Current Street Address:*
How Long?
City:*
State / Province:*
Postal Code:*
Country:
Phone:*
Previous Street Address:
How Long?
City:
State / Province:
Postal Code:
Country:
Have you worked for this company before?
- Yes
- No
From Date:
MM slash DD slash YYYY
To Date:
MM slash DD slash YYYY
Rate of Pay:
Position:
Reason for Leaving:
Are you now employed?
- Yes
- No
If not, how long since leaving your last employment?
Who referred you?
Rate of Expected Pay?
Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the job description?)
- Yes
- No
If yes, explain if you wish:

Education
Highest Grade Completed
Last School Attended:
City
Experience and Qualifications - Driver
Driver License Number:
Province
Type
Expiration Date:
MM slash DD slash YYYY
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
- Yes
- No
Has any license, permit or privilege ever been suspended or revoked?
- Yes
- No
Please Provide details:*
Driving Experience
If none, write NONE below
Straight Truck
Type of equipment

Van, Tank, Flat, etc.
From Date
MM slash DD slash YYYY
To Date
MM slash DD slash YYYY
Approx # of Miles (total)
Tractor & Semi-Trailer
Type of equipment
From Date
MM slash DD slash YYYY
To Date
MM slash DD slash YYYY
Approx # of Miles (total)
Tractor & Two Trailers
Type of equipment
From Date
MM slash DD slash YYYY
To Date
MM slash DD slash YYYY
Approx # of Miles (total)
Motorcoach - School Bus
Type of equipment
From Date
MM slash DD slash YYYY
To Date
MM slash DD slash YYYY
Approx # of Miles (total)
Other
Type of equipment
From Date
MM slash DD slash YYYY
To Date
MM slash DD slash YYYY
Approx # of Miles (total)
U.S. States operated in the past 5 years:
Provinces operated in the past 5 years:
Show special courses or training that will help you as a driver:
Which safe driving awards do you hold and from whom?

PLEASE READ CAREFULLY !*
- I understand and Agree with the following statements:
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize Spring Creek Carriers Inc. to make such investigations and inquiries of my personal employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. I hereby release employees, schools or persons from all liability in responding to inquiries in conjunction with my application. In the event of my 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, as permitted by law.
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