Driver Application

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Driver Application

Fill out the form below to apply online. We will review your application and be in touch as soon as possible. If you have any questions, please feel free to contact us online or at (800) 292-5010.

Commercial Driver Application

Company
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Applicant Information

Today's Date
Position applying for
ContractorDriverContractor's Driver
Name
Phone
Emergency Phone
Age
Date Of Birth
SS#
Physical Exam Expiration Date

Current & Previous Three Years Addresses

Please list the last three addresses you have lived at, including the starting month and year, and when you left.
Have you worked for this company before?
YesNo
If yes, what were your start and end dates? (e.g. 2/01/17 - 8/01/19)
Reason for leaving?

Education History

Highest level of education completed.
High SchoolSome CollegeCollege GraduatePost Graduate School

Employment History

Give a complete record of all employment for the past three (3) years, including any unemployment or self employment periods, and all commercial driving experience for the past ten (10) years.
Mo/Year From
Mo/Yr To
Present or Last Employer Name
Position Held
Address
Reason for leaving
Phone
Were you subject to the FMCSRs while employed here?
YesNo
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
YesNo

Mo/Year From
Mo/Year To
Position Held
Present or Last Employer Name
Address
Reason for leaving
Company Phone
Were you subject to the FMCSRs while employed here?
YesNo
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
YesNo

Mo/Yr From
Mo/Yr To
Present or Last Employer Name
Position Held
Address
Reason for leaving
Company Phone
Were you subject to the FMCSRs while employed here?
YesNo
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
YesNo

Mo/Yr From
Mo/Yr To
Present or Last Employer Name
Position Held
Address
Reason for leaving
Company Phone
Were you subject to the FMCSRs while employed here?
YesNo
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
YesNo

Mo/Yr From
Mo/Yr To
Present or Last Employer Name
Position Held
Address
Reason for leaving
Company Phone
Were you subject to the FMCSRs while employed here?
YesNo
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
YesNo

Mo/Yr From
Mo/Yr To
Present or Last Employer Name
Position Held
Address
Reason for leaving
Company Phone
Were you subject to the FMCSRs while employed here?
YesNo
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
YesNo

Driving Experience

Straight Truck
Start and End Date
Approx. Number of Miles
Tractor & Semi-trailer
Start and End Date
Approx. Number of Miles
Tractor & two trailers
Start and End Date
Approx. Number of Miles
Tractor & triple trailers
Start & End Date
Approx. Number of MMiles
Other
States operated in within the last five (5) years
Special courses/training completed (PTD/DDC, HAZMAT, ETC)
Safe Driving Awards you hold, and from whom

Accident Record for past three (3) years

Date of Accident
Nature of Accident (head on, rear end, etc)
Location of Accident
Number of Fatalities
Number of People Injured

Date of Accident
Nature of Accident (head one, rear end, etc)
Location of Accident
Number of Fatalities
Number of People Injured

Date of Accident
Nature of Accident (head on, rear end, etc)
Location of Accident
Number of Fatalities
Number of People Injured

Traffic Convictions and Forfeitures in the last three (3) years (other than parking violations)

Date
Location
Charge
Penalty

Date
Location
Charge
Penalty

Date
Location
Charge
Penalty

Drivers License (list each driver's license held in the past three (3) years)

State
License
Type
Edorsements
Expirate Date

State
License
Type
Edorsements
Expiration Date

State
License
Type
Edorsements
Expiration Date
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
YesNo
Has any license, permit or privilege ever been suspended or revoked?
YesNo
Is there any reason you might be unable to perform the functions of the job for which you have applied?
YesNo
Have you ever been convicted of a felony?
YesNo
If the answers to any questions issues above are "yes", give details.

References

Name
Address
Phone

Name
Address
Phone

Name
Address
Phone
To Be Read and Signed by Applicant It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty. It is agreed and understood that the motor carrier or his agent may investigate the applicant's background to obtain any and all information of concert to applicant's record, whether same is of record or not, and applicant releases employers and person named herein from all liability for any damages on account of his furnishing such information. It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating COnsumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. I agree to furnish such additional information and complete such examinations as may be required to complete my application file. It is agreed and understood that this Application in no way obligates the motor carrier to employ or hire the applicant. It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse. 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.
Applicant Name
Date

Verification

Please enter any two digits *Example: 12
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Bay Transportation, Inc.

2715 S. Huron Rd. Kawkawlin, MI 48631

(800) 292-5010

Driver Application

HOME

ABOUT

SERVICES

DRIVER APPLICATION

CONTACT US

Driver Application

Commercial Driver Application

Applicant Information

Current & Previous Three Years Addresses

Education History

Employment History

Driving Experience

Accident Record for past three (3) years

Traffic Convictions and Forfeitures in the last three (3) years (other than parking violations)

Drivers License (list each driver's license held in the past three (3) years)

References

Verification

Bay Transportation, Inc.

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