List your addresses of residency for the past 3 years:
- If yes,Dates:
Driver Minimum Guidelines
I have read and understand each of the preceding statements.
Drivers must be at least 24 years of age, with recent 3 years OTR verifiable Experience.
Drivers must furnish good phone numbers from all previous employers or carriers.
Drivers must hold CDL issued by their state of residence, and may only possess one license. The must also hold a valid DOT medical card by a DOT certified physician on the national registry.
Drivers can have no more than 2 moving violations, and no more than 2 preventable accidents in the previous 3 years. (no excessive speeding tickets and DUI’s or Felonies).
Drivers must have a regular service smartphone. (NO PREPAID CELL PHONE ALLOWED).
Owner-Operators must live within normal traffic lanes.
Drivers must be of good character and have a stable work history. They should be neat and clean and wear appropriate clothing. They must not wear clothing with obscene jesters or phrases, and obscene tattoos must be covered at all times.
All drivers will be required to pass a drug screen as required by the DOT. Drivers must not be disqualified under section 391.15 of Federal Motor Carrier Safety Regulations.
All drivers must be a citizen of the United States of America, or possess documentation showing their legal right to work, and legal residency in the United States.
Drivers must have personal transportation to and from work.
There will be a 90-day probationary period, during which time you will be evaluated on
both work habits and attitude, in so far as how well you perform and get along with other
owner operators, drivers, My-way employees, staff, customers and the public.
Independent Contractors must submit $50.00 with the application for processing all
Background checks and drug screen. This money is non-refundable.
Independent Contractors lease deposit is $2500.00. This deposit is required for all leases.
Your application will not be processed unless you have signed and dated this page.
Employment History Past 10 Years
Please give the following information regarding your current and previous employers. Start with the most recent. Use addition sheets if necessary and please explain any employment gaps.
- Date :
Truck Driving Applicants Previous Employment Reference Check
Applicant should only complete the bottom of this page at “Applicant Completes”
Note: The sections below are for My Way Safety Department and your former employer.By signing this form,you authorize My Way to contact your former employer to collect this information.
My Way Safety Department completes
Former Employer Completes
- 2] What were the dates the applicant was employed or contracted to your company?
- If Yes, how many?
Section 382.405 (i) and (h). FMCSR requires we request and you provide specific information set forth below. Section 382.413 (e). The release of any information under this section may take the form of personal interview, telephone interviews, and letters of any method of transmitting this information that ensure confidentiality. Our facsimile (FAX) capability allows for such confidentiality.) Part 382.413 provides employee can no longer perform safety sensitive function if 14-days elapse and this information has not been received
- PLEASE PROMPTLY RESPOND HERETO AND RETURN
Person who completed this reference:
As required in Sub Section 382.405 (f) and (h), my signatureauthorizes you, my former Employer above Identified, to release and provide to the above named prospective company any and all information regarding my alcohol and controlled substance (drug) testing / training records, including Substance Abuse Professional (SAP) reports, Record of Employment, Accident and Cargo Claims from any and all of my current and / or former employers where I have worked during the past 10 years.
APPLICANT COMPLETES - Driving Qualifications And Experience
(Please complete if applicable)
(Please complete if applicable)
Tractor w/ Two-Trailer
(Please complete if applicable)
(Please complete if applicable)
Accidents And Violations
TRAFFIC CONVICTIONS IN THE PAST THREE YEARS (Not parking violations)
Education And Training
Please provide the following information about completed education, starting with the most recent.
Please provide three personal reference. These references should not be people related to you nor former supervisors.
Carefully Read The Following - you will sign this application on the next page.
By signing this statement, I certify that this employment application has been completed by me, and all of the entries provided are true, complete, and accurate, to the best of my knowledge. By signing below I also authorize this company to make such inquiries into my employment, financial, personal, or medical history as might be needed to make an employment decision. I understand that inquiries into my medical history are generally made after a job offer is made.
I hereby release my former employers, healthcare providers and schools from any and all liability in making response to these inquiries and from releasing the requested information.
(Do not write below this line – Office use only)
THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY ALL ACCOUNT HOLDERS IMPORTANT DISCLOSURE REGARDING BACKGROUND REPORTS FROM THE PSP Online Service
In connection with your application for employment with My Way Transportation, Inc.("Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Adminisfration (FMCSA).
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.
When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or elecfronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.
Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization.
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:
I authorize My Way Transportation, Inc.("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.
I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.
I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.
This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant's written or electronic consent prior to accessing the Applicant's PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant's consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language.