Commercial Driver Job ApplicationMapleton Oil Co., Inc. is accepting applications for Delivery Driver and Tanker Driver positions. Complete all required fields and provide accurate information.Mapleton Oil Co., Inc. is an equal opportunity employer.1. Applicant & Position InformationTell us how to contact you and which driver position interests you.Application Date *Position Applied For *Delivery Driver — Class B CDLTanker Driver — Class A CDLBoth PositionsEmployment Type Desired *SeasonalPart TimeFull TimeFirst Name *Middle NameLast Name *Email Address *Primary Phone *Alternate PhoneWho Referred You?Expected Rate of PayHave you worked for Mapleton Oil before? *YesNoPrevious Mapleton Oil Employment DetailsIf yes, provide dates, location, rate of pay, position, and reason for leaving.Current Address *Street address, city, state, and ZIP code.Have you lived at this address for at least three years? *YesNoPrevious Residence 1Previous address and dates of residence.Previous Residence 2Add another address if needed to complete the three-year history.Names of Relatives Employed by Mapleton OilAre You Currently Employed? *YesNoIf not employed, how long since your last employment?2. Education, Military & General BackgroundHighest Education Completed *Select one8th Grade or Below9th Grade10th Grade11th GradeHigh School Diploma or GEDSome CollegeAssociate DegreeBachelor’s DegreeGraduate DegreeYears of College CompletedSelect oneNone1234+Last School AttendedSchool name and address.Have You Served in the U.S. Armed Forces? *YesNoBranch of ServiceRelevant Military TrainingCurrently Serving in the Military Reserves? *YesNoCurrently Serving in the National Guard? *YesNoHave You Ever Been Bonded?YesNoName of Bonding CompanyHave You Ever Been Convicted of a Felony? *YesNoFelony ExplanationIf yes, explain. Conviction of a crime is not an automatic bar to employment; all circumstances will be considered.3. Driver Experience & QualificationsFederal Motor Carrier Safety Regulations require driver applicants to provide qualification information.Date of Birth *Social Security Number *Sensitive information. This value is stored with the protected WordPress submission and is intentionally excluded from notification emails.Years Holding a Class A CDL *Years Holding a Class B CDL *Hazmat Certification? *YesNoTanker Certification? *YesNoTWIC Card? *YesNoProficient with Electronic Log Books? *YesNoAble to Comply with All State and Federal DOT Regulations? *YesNoPhysical History49 CFR 391 Subpart E requires driver applicants to meet applicable physical qualifications.Date of Last DOT Examination *Can You Provide a Copy? *YesNoHave You Received a Waiver Under 49 CFR 391.49? *YesNoWaiver DetailsIf yes, explain the waiver involving loss or impairment of a foot, leg, hand, or arm.4. Alcohol & Controlled Substance Statement49 CFR 40.25(j) requires applicants for CDL safety-sensitive positions to answer these questions.Within the last two years, did you test positive or refuse a pre-employment drug or alcohol test for safety-sensitive transportation work? *YesNoWithin the last two years, did you test positive or refuse a drug or alcohol test while performing safety-sensitive transportation work? *YesNoCan You Provide Proof of Completed DOT Return-to-Duty Requirements? *YesNoNot ApplicableDrug and Alcohol Testing ExplanationProvide relevant details for any yes response.Driver’s License InformationDriver’s Licenses Held During the Past Three Years *For each license, provide state, license number, class/type, endorsements, and expiration date. Enter each on a separate line.Ever Denied a License, Permit, or Privilege to Operate a Motor Vehicle? *YesNoHas Any License, Permit, or Driving Privilege Been Suspended or Revoked? *YesNoEver Disqualified for Violations of Federal Motor Carrier Safety Regulations? *YesNoLicense Denial, Suspension, Revocation, or Disqualification Details5. Driving ExperienceProvide complete commercial driving experience.Driving Experience Record 1 *Equipment class, equipment type, dates operated, and approximate total mileage.Driving Experience Record 2Add another equipment and experience record if applicable.Driving Experience Record 3Add another equipment and experience record if applicable.States Operated In During the Last Five Years *Special Courses or Driver TrainingSafe Driving AwardsList each award and the organization that presented it.Accident HistoryAccident History for the Past Three Years *If none, enter “None.” For each accident provide date, nature of accident, fatalities, injuries, vehicles towed, and whether a citation was issued.Motor Vehicle Driving RecordTraffic Convictions and Forfeitures During the Past Three Years *Exclude parking violations. If none, enter “None.” For each incident provide date, location, charge, and penalty.6. Employment RecordProvide all employment for the last three years. If you previously drove a commercial vehicle, provide an additional seven years for a total of ten years. Begin with the current or most recent employer and explain every gap.Current or Most Recent Employer *Provide employer name, supervisor, complete mailing address, phone, position held, salary or rate, start date, end date or Current, and reason for leaving.Previous Employer 1 *Provide employer name, supervisor, complete mailing address, phone, position held, salary or rate, start date, end date or Current, and reason for leaving.Previous Employer 2Provide employer name, supervisor, complete mailing address, phone, position held, salary or rate, start date, end date or Current, and reason for leaving.Previous Employer 3Provide employer name, supervisor, complete mailing address, phone, position held, salary or rate, start date, end date or Current, and reason for leaving.Additional Employment HistoryAdd any additional employment needed for a complete three-year or ten-year history.Employment Gaps *Explain every employment gap. If there were none, enter “None.”7. Applicant Certification & Electronic SignatureApplicant Must Read and SignI certify that I have read and understand this employment application. I understand and agree that Mapleton Oil Co., Inc. or its agents may investigate my background to obtain information relevant to my application, whether or not that information is a matter of public record. I release employers and other persons named in this application from liability for providing such information. I understand that I may be asked to demonstrate my ability to perform tasks pertinent to the position.I understand that any investigation may include an investigative consumer report involving information about my character, general reputation, personal characteristics, and mode of living, as permitted by applicable law. I agree to provide additional information and complete examinations that may be required to complete my employment file.I understand that any misrepresentation or omission may result in rejection of my application or dismissal from employment. If hired, I agree to follow all rules and policies of Mapleton Oil Co., Inc. I certify that I completed this application and that all information provided is true and complete to the best of my knowledge.Applicant Certification *I have read, understand, and agree to the Applicant Certification above, and I certify that the information in this application is true and complete to the best of my knowledge.Typed Electronic Signature *Type your full legal name. Typing your name constitutes your electronic signature.Signature Date *Final Acknowledgments *I understand that employment is subject to a background check and drug test.I understand that starting wage, benefits, and scheduling will be discussed at the interview.I understand that Mapleton Oil Co., Inc. is an equal opportunity employer.Submit Driver Application
