Application for Employment

I am applying for one of the following positions -
Full-Time
Part-time
Other

I have the following driving experience: (Please check all that apply) -
Truck Driver School Training
Apprentice Training Program
Experienced Truck Driver
Does not apply

Enter years of experience:(Enter 0 if less than one):

Date of Birth -

First Name -

Middle Initial -

Last Name -

Address -

City -

State - Please Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code -

Home Phone -

Cell Phone -

Email -

Have you ever been known by any other name? -
Yes
No

Other Name(s):

If employed, can you provide verification of your legal right to work in the United States? -
Yes
No

Can you legally travel between the United States and Canada? -
Yes
No

if no, please explain:

Who referred you to our Company?

Have you ever been convicted of a felony, received a deferred prosecution, or have any felony charges currently pending? -
Yes
No

Dates and Details:

Have you ever been convicted of a misdemeanor, received a deferred prosecution, or have any misdemeanors charges currently pending? -
Yes
No

Dates and Details:

Have you ever been convicted of operating a motor vehicle while under the influence of alcohol or a controlled substance, or are any charges pending, including reduction to a lesser charge? -
Yes
No

Dates and Details:

Have you ever been convicted of possession, sale, transfer or use of alcohol or a narcotic drug, amphetamine, inhalant, or derivative thereof, or have a current charge pending? -
Yes
No

Dates and Details:

Have you ever tested positive for drugs/controlled substance or alcohol, or refused to submit to alcohol/drug testing? -
Yes
No

Dates and Details:

Have you ever been denied a license, permit or privilege to operate a motor vehicle? -
Yes
No

Dates and Details:

Has any driver's license, permit, or privilege ever been suspended or revoked? -
Yes
No

Dates and Details:

Have you ever had a citation for leaving the scene of an accident? -
Yes
No

Have you ever worked for this company before? -
Yes
No

If yes, when (MM/YYYY):

Position worked at this Company:

Period of non-employment dates (MM/YYYY - MM/YYYY):

Reason:

Employed from (MM/YYYY - MM/YYYY):

Full Time/Part Time:
Full Time
Part Time

Miles Driven Weekly:

Company Name:

Address:

City:

State Please Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code:

Phone:

Position Held:

Truck Type:
Semi
Straight

Pay Rate:

Were you subject to the FMCSR's?
Yes
No

Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the Drug & Alcohol testing requirements of 49 CFR Part 40?
Yes
No

Reason for leaving?

May we contact this employer?
Yes
No

Period of non-employment dates (MM/YYYY - MM/YYYY):

Reason:

Employed from (MM/YYYY - MM/YYYY):

Full Time/Part Time:
Full Time
Part Time

Miles Driven Weekly:

Company Name:

Address:

City:

State Please Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code:

Phone:

Position Held:

Truck Type:
Semi
Straight

Pay Rate:

Were you subject to the FMCSR's?
Yes
No

Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the Drug & Alcohol testing requirements of 49 CFR Part 40?
Yes
No

Reason for leaving?

Period of non-employment dates (MM/YYYY - MM/YYYY):

Reason:

Employed from (MM/YYYY - MM/YYYY):

Full Time/Part Time:
Full Time
Part Time

Miles Driven Weekly:

Company Name:

Address:

City:

State Please Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code:

Phone:

Position Held:

Truck Type:
Semi
Straight

Pay Rate:

Were you subject to the FMCSR's?
Yes
No

Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the Drug & Alcohol testing requirements of 49 CFR Part 40?
Yes
No

Reason for leaving?

All applicants of Fetter and Son must agree to the Applicant Agreement
I have read and understand the terms of the Applicant Agreement -

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