Driver Application Personal Information Name: Date: Phone: (xxx-xxx-xxxx) Email: Address: City/State/Zip: Social Security #: Date Available Desired Pay Are you Over 18-year-old: Yes No Employment Desired Full Time Part Time Seasonal All Options Preferred Shift Early Afternoon Both Work Location Desired Conshohocken West Norriton Both List Days Available To Work Educational Background High School (Check highest level completed): 9 10 11 12 College Trade/Vocational (or other) Training Work Experience Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. 1. Name of Employer Address Phone number (xxx-xxx-xxxx) Supervisors Name: Employed From: To: Position: Reason for leaving (be specific) : List the jobs you held, duties performed, skills acquired, advancements or promotions while you worked at this company. 2. Name of Employer Address Phone number (xxx-xxx-xxxx) Supervisors Name: Employed From: To: Position: Reason for leaving (be specific) : List the jobs you held, duties performed, skills acquired, advancements or promotions while you worked at this company. 3. Name of Employer Address Phone number (xxx-xxx-xxxx) Supervisors Name: Employed From: To: Position: Reason for leaving (be specific) : List the jobs you held, duties performed, skills acquired, advancements or promotions while you worked at this company. Additional Information Are you currently employed? Yes No May we contact your present employer? Yes No Did you complete this application yourself? Yes No If not, who did? Have you ever been convicted of a felony? Yes No If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation. If hired, can you provide proof of U.S. Citizenship? Yes No Or proof of your legal right to live and work in this country? Yes No Do you have a valid Driver’s License? Yes No Have you ever been employed with this company? Yes No If yes, when? Do you have any friends or relatives employed by this company? Yes No If yes, please provide their names and relationship to you. If hired, would you have a reliable means of transportation to and from work? Yes No Have you had any moving violations or accidents in the last 3 years? Yes No If so, Explain Personal References (Other than family members or previous employers) 1. Name Relationship Company Name: Phone Number: (xxx-xxx-xxxx) Email: 2. Name Relationship Company Name: Phone Number: (xxx-xxx-xxxx) Email: Motor Vehicle Records Check Are you willing to consent to have your Driver License record checked? Yes No Optional Please list any additional information you would like us to know about you: Application understands that this is an Equal Opportunity Employer and committed to excellence through diversity. Please complete each section even if you decide to attach a resume. I, the Applicant certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated. Type your name Dated * Please sign the form electronically on the next page after submitting here.
