Form Part 1

Driver’s Application for Employment

State(s) Applying For: (check all that apply)
AZNMTX
Type of Driver Position Applying for: (check all that apply) RegionalLocal
Position Applies for: DRIVERS POSITION

In compliance with Federal and State equal employment opportunity laws; qualified driver applicants are considered for driver positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, or any other protected group status.

To Be Read and Signed by Applicant

I authorize Central Arizona Freight Inc. to make such investigations and inquires as needed of my personal, driving,
criminal, employment, financial and or medical history and other related matters as may be necessary in arriving at an
employment decision. I hereby release all persons, employers, schools, health care providers and other
person’s from all liability in responding to inquires and releasing information in connection with my application.
In the event of employment, I understand that any incorrect, false or misleading information given in my application or
during the employment interview(s) may result in discharge. I understand that I am required to abide by All Federal
Motor Carrier Safety Administration regulations and all policies, rules, and regulations of Central Arizona Freight Inc.
I understand that information I provide regarding current and/or previous employers may be used, and those
employer(s) will be contacted, for the purpose of investigating my safety performance history as required by FMCSA
49 CFR 391.23(d) and (e). I understand that I have the right to:
● Review information provided by previous employers:
● Have errors in the information corrected by previous employers and for those previous employers to re-send
the corrected information to the prospective employer; and
● Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I
cannot agree on the accuracy of the information.
I understand that I must serve a 90-day probation period during which my abilities to perform the duties of the
position applied for will be monitored and evaluated. Failure to meet the company’s and FMCSA’s expectations can
result in termination of my employment.

Driver Employment Applicant

Answer all Questions

US Military Veteran:
YesNo

List All Addresses You Have Had During The Last 10 Years, other Than Your Current Address:










Do you have the legal right to work in the United States? YesNo

Can you provide proof of age? YesNo
Have you worked for this company before? YesNo

Are you now employed? YesNo

Have you ever been bonded?YesNo

Have you ever been convicted of any felony?YesNo

Is there any reason(s) you might be unable to perform the required skills and duties of a CMV Driver position covered under the FMCSA’s regulations, for the position for which you have applied (as described in the attached job description)? YesNo