American Limo Network

Preliminary Driver's Application for Employment

(answer all questions)

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disability.
   
Position (s) Applied for
First Name:
Last Name:
Contact Number:
SSN# xxx-xxx-xxxx
Address
City
State
Zip
Do you have the legal right to work in the United States? Yes No
Date of Birth / /
Can you provide proof of age? Yes No
Have you ever worked for this company before Yes No
If Yes - Where?
Dates: From To: Rate of Pay:
Position:
Reason for leaving
Are you now employed Yes No
If not, how long since leaving last employment? Month(s) Year(s)
Who referred you?
Rate of pay expected
Is there any reason you might be unable to perform the functions of the job for which you have applied. Yes No

If yes, explain if you wish.
If you are accepted for a position with ALN - American Limo Network - are you able to provide a complete 10 year history of past employment - no gaps - including vacations and unemployment periods?. Yes No

If the answer is No, please explain
EMPLOYER 1
Name:
Address:
City: State:
Contact Person: Phone:
DATE
From: To
Position
Salary/wage
Reason for Leaving
 
EMPLOYER 2
Name:
Address:
City: State:
Contact Person: Phone:
DATE
From: To
Position
Salary/wage
Reason for Leaving
 
EMPLOYER 3
Name:
Address:
City: State:
Contact Person: Phone:
DATE
From: To
Position
Salary/wage
Reason for Leaving
 
Accident Record for Past 3 years or more - if none, write NONE
Dates Nature of Accident
(Head-On, Rear-End, Upset, Etc.)		 Fatalities Injuries
Last Accident
month/date/year
Please Explain >>>>>
Yes
No
Yes
No
Next Previous
month/date/year
Please Explain >>>>>
Yes
No
Yes
No
Next Previous
month/date/year
Please Explain >>>>>
Yes
No
Yes
No
 
Traffic Convictions and Forfeitures for the Past 3 Years
(other than parking violations) if none, write NONE - in location field
Location Date m/d/y Charge Penalty
 
Education
Select Highest Grade Completed
High School
College
Last School Attended (name/city)
 
Experience and Qualifications - Driver
DRIVER

LICENSES
State
License No.
Type
Expire Date
 
A. Have you ever been denied a license, permit or privilege to
operate a motor vehicle?		 Yes No
B. Has any license, permit or privilege ever been suspended
or revoked?		 Yes No
 
Driving Experience - If none, write NONE
Class of Equipment Type of Equipment
(Van, Tank, Flat, etc.)
Dates
From
To
Approx. No. of
Miles (total)
Straight Truck
Tractor and Semi-Trailer
Tractor - Two Trailers
Motorcoach - School Bus
Other

   

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