Online Driver Application

Personal Information
Position Currently Applying For:
First Name:
Last Name: Social Security #:
Email Address:
Phone:
Address:
City: State: Zip:
Date of Birth:
     
 
 
Have you ever worked for Ezzell Trucking? Yes No
  
Are you legally eligible to work in the United States? Yes No    
If referred by an Ezzell driver please list name.

Experience: Years Months
(If no Driving School, write None and N/A for the Dates)
Driving School: Dates:
Traffic Violations in the last 3 years: Accidents in the last 3 years:
 




DRIVERS LICENSE: LIST ALL DRIVER LICENSES HELD IN PAST FIVE YEARS
State
License Number
Class
Endorsement
Expiration Date
If you have held a drivers license in any other name within the last 10 years, please provide the other name(s):
Last: First: Middle:
TRAFFIC CONVICTIONS AND FORFEITURES, OTHER THAN PARKING VIOLATIONS: LIST FOR PAST FIVE YEARS
Include On-Duty or Off-Duty and while in either a commercial or personal vehicle. If None, write none.
Date
City/State
Charge-if speeding, how fast?
Penalty



ACCIDENT RECORD
List all accidents within the last five years regardless of whether it involved a commercial or personal vehicle.
Include preventable and non-preventable accidents and any that involved property damage. If none, write none.
Date
Type of Vehicle
Nature of Accident (Head-on, Rear-end, Etc.)
Preventable or
Non-Preventable
Fatalities Yes/No
Injuries Yes/No
Amount of Property Damage
City/State
Employer



Have you ever been denied a license, permit, or privilege to operate a motor vehicle? Yes No
Has your motor vehicle operator's license, permit or privilege been suspended or revoked? Yes No
Ever convicted of DUI/DWI? Yes No
Ever tested positive or refused a Drug/Alcohol Screen? Yes No
Ever been Convicted of a Felony? Yes No
   
If yes to any of the above, provide statement below giving details.



 
     

Employment History

    
Most Recent Employer:
 
Address:
City: State: Zip:
Phone:
Equipment Driven:
Position Held:
Start: End: Salary:
Reason for Leaving: Accidents:
         
 
Previous Employer:
 
Address:
City: State: Zip:
Phone:
Equipment Driven:
Position Held:
Start: End: Salary:
Reason for Leaving: Accidents:
 
Previous Employer:
 
Address:
City: State: Zip:
Phone:
Equipment Driven:
Position Held:
Start: End: Salary:
Reason for Leaving: Accidents:
 
Previous Employer:
 
Address:
City: State: Zip:
Phone:
Equipment Driven:
 
Position Held:
Start: End: Salary:
Reason for Leaving: Accidents:
 
Previous Employer:
 
Address:
City: State: Zip:
Phone:
Equipment Driven:
Position Held:
Start: End: Salary:
Reason for Leaving: Accidents:
 
Previous Employer:
 
Address:
City: State: Zip:
Phone:
Equipment Driven:
Position Held:
Start: End: Salary:
Reason for Leaving: Accidents:
 
Previous Employer:
Address:
City: State: Zip:
Phone:
Equipment Driven:
Position Held:
Start: End: Salary:
Reason for Leaving: Accidents:
     
Comments:

By submitting this form to Ezzell Trucking, you understand that Ezzell Trucking may
investigate your background and work history. Submission of this application is an
agreement to any possible background/work history investigation. If you agree to these
terms, please press the 'Submit' button to send your online application to Ezzell Trucking.