form test « Krueger Trucking

Employment Application (1)

Krueger Trucking Employment Application.

This is not a legal or official application for employment. After completing this form a member of our team will review the information and contact you to setup a short phone interview if your skills and background match an open opportunity. You may be asked to complete this form again in person.
Name*
First Last
Your Address*
Street Address Address Line 2 City State ZIP Code
Your Phone
Enter the number where we can reach you during work hours. Either a phone number OR email address is required or we have no way to contact you.
Your Email Address*

If you do not have email you can get a free account on mail.google.com, mail.yahoo.com or mail.live.com.
Employment Eligibility*
- I am eligible to work in the United States
- I have a valid Social Security Number
- I can produce the documents upon request
Please check all that apply.
Date of Birth*
Social Security Number*
Position Information
What position are you interested in?*
Position choices are general and may not match specific job openings.
How did you hear about the position?*
- Advertisement
- Friend or Relative
- Online Search
Employment History - Current or Most Recent Employer
Starting with most recent employer, please provide your work experience. Please complete this information even if you upload a resume.
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Company Phone
Enter the general company phone number or supervisor's number if known.
Supervisor's Name
Job Duties and Reason for leaving
From Date
MM slash DD slash YYYY

Employment Start
To Date
MM slash DD slash YYYY

Leave blank if still employed here.
May we contact current employer?
- Yes
- No
Previous Employment
Company Name (2nd Employer)
Company Address (2nd Employer)
Street Address Address Line 2 City State ZIP Code
Company Phone (2nd Employer)
Enter the general company phone number or supervisor's number if known.
Supervisor's Name (2nd Employer)
Job Duties and Reason for leaving (2nd Employer)
From Date
MM slash DD slash YYYY

Employment Start
To Date
MM slash DD slash YYYY

Leave blank if still employed here.
May we contact 2nd Employer?
- Yes
- No
Company Name (3rd Employer)
Company Address (3rd Employer)
Street Address Address Line 2 City State ZIP Code
Company Phone (3rd Employer)
Enter the general company phone number or supervisor's number if known.
Supervisor's Name (3rd Employer)
Job Duties and Reason for leaving (3rd Employer)
From Date
MM slash DD slash YYYY

Employment Start
To Date
MM slash DD slash YYYY

Leave blank if still employed here.
May we contact 3rd Employer?
- Yes
- No
Company Name (4th Employer)
Company Address (4th Employer)
Street Address Address Line 2 City State ZIP Code
Company Phone (4th Employer)
Enter the general company phone number or supervisor's number if known.
Supervisor's Name (4th Employer)
Job Duties and Reason for leaving (4th Employer)
From Date
MM slash DD slash YYYY

Employment Start
To Date
MM slash DD slash YYYY

Leave blank if still employed here.
May we contact 4th Employer?
- Yes
- No
Company Name (5th Employer)
Company Address (5th Employer)
Street Address Address Line 2 City State ZIP Code
Company Phone (5th Employer)
Enter the general company phone number or supervisor's number if known.
Supervisor's Name (5th Employer)
Job Duties and Reason for leaving (5th Employer)
From Date
MM slash DD slash YYYY

Employment Start
To Date
MM slash DD slash YYYY

Leave blank if still employed here.
May we contact 5th Employer?
- Yes
- No
Military Service
Have you served in the U.S. Armed Forces?*
- Yes
- No
You may be asked to provide documentation of status.
Branch of Service
Honorable Discharge?
- Yes
- No, Still serving
(Optional - Upload Resume)
Adding a resume is a nice way to provide some additional information and especially helpful for office jobs.
Resume Upload Option
Accepted file types: doc, pdf, txt, Max. file size: 10 MB.
Upload a MS Word Document, PDF File or Text Document. No other file types are allowed.
Questions for Owner/Operator Candidates Only
If you are interested in technician or office work you do not need to complete the driver specific questions. Owner/Operator candidates - please complete the information requested.
Driver's License Number
Driver's License State
Driver's License Expiration Date
Month
Day
Year
Number of Years Driving Exp.
Please enter a number from 0 to 99.
How many total years of commercial driving expereince do you have?
Endorsements: Do you have...
- A CURRENT CDL class license
- Combination vehicles over 26,000 Lbs.
- Hazardous materials
- Air Brakes
If yes, check all that appy.
Driving Record
Please tell us about any accidents or tickets in last three(3) years. Include the dates, injuries, what happened, criminal charges, etc. KruegerTrucking, Inc. will pull an official driving record prior to employment so please explain fully. Thank you.
Have you EVER...
- been denied a license, permit or privilege to operate a motor vehicle?
- had any license permit or privilege suspended or revoked?
- been convicted for driving while under the influence of alcohol or drugs?
- been refused liability insurance?
- been convicted of a felony?
- been disqualified to drive by Federal Regulations?
- tested positive, or refused to take a pre-employement alcohol/drug screening, whether the employer hired you or not, wihtin the past two(2) years?
Checking the box means "Yes, I have". Please explain any "Yes" marks in the box below.
Explanations
If you answered "YES" to ANY of the above questions please explain your answers here.
Driving Experience
Straight Truck
From
DD slash MM slash YYYY
To
DD slash MM slash YYYY
Approximate Number of Miles-Total
Tractor and Semi-Trailer
From
DD slash MM slash YYYY
TO
DD slash MM slash YYYY
Approximate Number of Miles-Total
Tractor-Two-Trailers
From
DD slash MM slash YYYY
To
DD slash MM slash YYYY
Approximate Number of Miles-Total
Tractor-Three Trailers
From
DD slash MM slash YYYY
To
DD slash MM slash YYYY
Approximate Number of Miles-Total
Others-

What type of setup?
From
DD slash MM slash YYYY
To
DD slash MM slash YYYY
Approximate Number of Miles-Total
List states operated in, for the last five years:
List special courses/training completed(PTD/DDC, Hax Mat, etc.):
List any Safe Driving Awards you hold and from whom
Accident Record for past three years(attach sheet if more space is needed)
Date of Accident
DD slash MM slash YYYY
Nature of Accident(Head on, read end, upset, etc)
Location of Accdent
# of Fatalities
# of People injured
Date of Accident
DD slash MM slash YYYY
Nature of Accident(Head on, read end, upset, etc)
Location of Accdent
# of Fatalities
# of People injured
Date of Accident
DD slash MM slash YYYY
Nature of Accident(Head on, read end, upset, etc)
Location of Accdent
# of Fatalities
# of People injured
Traffic Convictions and Forfietures for the last three years(other than parking violations)
Date
DD slash MM slash YYYY
Location
Charge
Panalty
Date
DD slash MM slash YYYY
Location
Charge
Penalty
Date
DD slash MM slash YYYY
Location
Charge
Penalty
Is There ay reason yon might be unable to perform the functionsof the job for which you have Applied(as described in the job description)?
- Yes
- No
To applicant: Read this information carefully before submitting the application!
It is agreed and understood that any misrepresentations of information given above shall be considered an act of dishonesty.

It is agreed and understood that the motor carrier or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, where same is of record or not and applicant releases employers and persons named herein form all liability for any damages on account of his furnishing such information.

It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.

I agree to furnish such additional information and complete such examinations as may be required to complete his employment file.

It is agreed and understood that this application for employment in no way obligates the motor carrier to employ or hire the applicant.

It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be discharged without recourse.

This certified that this application was completed by me, and that all entries on it and information in it are true and complete to the best of knowledge.

form test

Employment Application (1)

Position Information

Employment History - Current or Most Recent Employer

Previous Employment

Military Service

(Optional - Upload Resume)

Questions for Owner/Operator Candidates Only