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Date of Application:
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Position Applying for:
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Full Time or Part Time
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Full Time
Part Time
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First Name:
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Last Name:
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MI
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Street Address:
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City:
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State:
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Home Phone Number: xxx-xxx-xxxx
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Cell Phone Number: xxx-xxx-xxxx
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Previous address if less than 3 years: Please list street address, city state zip code and how long you resided at previous address.
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Are you a U.S. Citizen or lawfully y in the U.S. and eligible for work? If employed, you must provide documentation
establishing that you may be legally employed in the U.S.
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Yes
No
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Emergency Contact Information: Please give full name address, city, state, zip code and phone number
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Are you currently employed?
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Yes
No
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Where?
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May we contact your current employer?
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Yes
No
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When would you be available to start work?
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Are you fluent in any foreign language?
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Yes
No
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If fluent in any Languages, what languages?
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Do you have any relatives working for ITS?
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Yes
No
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Who?
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Referred by?
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Have you ever been convicted of a felony?
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Yes
No
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If so, please explain
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Have you ever served in the Military
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Yes
No
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Branch Served:
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Dates Served: i.e Dec 1994 - Oct 2007
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Rank at Discharge:
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Date of Discharge:
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Type of Discharge:
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Select your highest level of education?
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Last school attended?
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Did you recieve a degree?
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Yes
No
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If you earned a degree, please list your major:
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Current or Previous Employer #1:
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Supervisor Name:
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Phone:
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Current or Previous Employer #1: List address, street, city state, zip code
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Position Held:
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Dates of Employment: (From - To)
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Salary:
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Reason For Leaving:
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Previous Employer #2:
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Supervisor Name:
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Phone:
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Previous Employer #2: List address,street, city, state, zip code
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Position Held:
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Dates of Employment: (From - To)
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Salary:
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Reason For Leaving:
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Previous Employer #3:
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Supervisor Name:
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Phone:
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Previous Employer #3:address, street,
city, state, zip code
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Position Held:
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Dates of Employment: (From - To)
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Salary:
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Reason For Leaving:
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Current License #:
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State:
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Endorsements:
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Restrictions:
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Class:
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Expiration Date:
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Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
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Yes
No
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If you answered yes above, what year?:
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Has any license, permit or privilege ever been suspended or revoked?
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Yes
No
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If you answered yes above, what year?:
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Have you ever been disqualified from operating any motor vehicle by any Federal,
State, or local enforcement agency?
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Yes
No
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If you answered yes above, what year?:
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If the answer to any of the above is yes, then attach a statement giving the details.
1. Class of Equipment (Straight Truck, Tractor and Semi-Tractor, Tractor- Two Trailer, Other
2. Type of Equipment (van, tank, flat, etc)
3. Dates: From - To
4. Approximate # of miles (total)
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List States operated in over the past 10 years:
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Show any special courses or training received that will help you as a driver:
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What safe driving awards do you hold and from where?:
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LIST ALL CHARGEABLE AND NON-CHARGEABLE ACCIDENTS (ANY VEHICLE, COMPANY OR PERSONAL). List Date (Mo/Yr), Accident Details, Fatalities, Injuries
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LIST ALL TRAFFIC CONVICTIONS AND FORFEITURES (ANY VEHICLE, COMPANY OR PERSONAL. List location, Date (Mo/Yr, Charge , Penalty
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DOCK / PLATFORM EXPERIENCE. List Type of Equipment, Company, From To dates, Special Courses
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Please list any other driving or dock / platform skills, courses or experience you may have which would aid us in determining your
qualifications:
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Attach your resume here:
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Please feel free to add any additional comments. We look forward to hearing from you!
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Your Email Address:
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