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Driver Employment

Answer all questions. If the answer to any question is “No” or “None”, do not leave the item blank, but write “No” or “None”.This is important! Age Discrimination of Employment Act of 1967 prohibits discrimination on the basic of age with respect to individuals for all positions without regard to race, color, religion, sex, national origin, age marital status, or veteran status.

APPLICATION FOR QUALIFICATION

The purpose of this application is to determine if the applicant is qualified to operate motor carrier equipment according to the requirements of the Federal Motor Carrier Safety Regulations and Alcatraz, LLC.

INSTRUCTIONS TO APPLICANT

Answer ALL questions. If the answer to any question is “No” or “None,” write “No” or “None”. Do NOT leave the item blank. This is important! Age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals for all positions without regard to race , color ,religion, sex, national origin, age marital status, veteran status.
First Name
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Middle Name
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Last Name
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Phone Number
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Emergency Phone Number
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Date of Birth
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Social Security Number
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Medical Exam Expiration Date
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Current and previous three years addresses:
Current Address
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From
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To
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Previous Address 1
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From
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To
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Previous Address 2
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From
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EDUCATION

Grade School:
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College
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Post –Graduate
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EMPLOYMENT HISTORY

Give a COMPLETE RECORD of all employment for the past three (3) years, including any unemployment or self employment periods, and all commercial driving experience for the past ten (10) years.
Mo/Yr From:
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Mo/Yr To:
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Present or Last Employer Name
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Position Held:
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Address:
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Reason for leaving:
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Company Phone:
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Were you subject to the FMCSRs while employed here?
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Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
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Mo/Yr From:
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Mo/Yr To:
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Present or Last Employer Name
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Position Held:
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Address:
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Reason for leaving:
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Company Phone:
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Were you subject to the FMCSRs while employed here?
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Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
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Field is required!
Mo/Yr From:
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Mo/Yr To:
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Present or Last Employer Name
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Position Held:
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Address:
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Reason for leaving:
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Company Phone:
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Were you subject to the FMCSRs while employed here?
Field is required!
Field is required!
Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
Field is required!
Field is required!

EXPERIENCE

Class of Equipment
Light Truck
From
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To
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Approximate Mileage
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Tractor & Semitrailer
From
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To
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Approximate Mileage
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Tractor & two trailers
From
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To
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Approximate Mileage
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Notes operated in the last five years:
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List special courses/training completed (PTD/DDC, HAZMAT, ETC):
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List any Safe Driving Awards you hold and from whom:
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PRESENT RECORD FOR PAST THREE YEARS

Date of Accident
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Nature of Accidents
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Location of Accident
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# of Fatalities
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# of People Injured
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Date of Accident
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Nature of Accidents
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Location of Accident
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# of Fatalities
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# of People Injured
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Date of Accident
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Nature of Accidents
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Location of Accident
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# of Fatalities
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# of People Injured
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Date of Accident
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Nature of Accidents
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Location of Accident
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# of Fatalities
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# of People Injured
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CONVICTIONS AND FORFEITURES FOR THE LAST THREE YEARS

(other than parking violations)
Date
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Location
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Charge
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Penalty
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Date
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Location
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Charge
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Penalty
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Date
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Location
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Charge
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Penalty
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Date
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Location
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Charge
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Penalty
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DRIVER'S LICENCE

(list each driver’s license held in the past three(3) years)
Date
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Licence
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Type
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Endorsements
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Expiration Date
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Date
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Licence
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Type
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Endorsements
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Expiration Date
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Date
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Licence
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Type
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Endorsements
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Expiration Date
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Date
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Licence
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Type
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Endorsements
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Expiration Date
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A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?
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B: Has any license, permit or privilege ever been suspended or revoked?
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C: Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the job description)?
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D. Have you ever been convicted of a felony?
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If the answers to A,B,C,or D is ‘YES’,give detailes:
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PERSONAL REFERENCES

Three persons for references ,other than family members, who have knowledge of your safety habits.
Name
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Address
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Phone
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Name
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Address
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Phone
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Name
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Address
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Phone
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ACKNOWLEDGMENT BY APPLICANT:

I agree and understand that any misrepresentation given on this application for qualification shall be considered an act of dishonesty.
The motor carrier and its agents or representatives have the right to investigate all references and to secure additional information for any employment background. I hereby release from all liability for damages the motor carrier and its agents or representatives seeking such Information and all other persons, corporations or organizations for furnishing such information. To furnish such additional information and complete such examinations as may be required to complete my employment file.
I agree and understand that this application for qualification in no way obligates the motor carrier to employ me. I agree and understand that if I qualify to operate motor carrier equipment, I may be on a probationary period, during which I agree to be disqualified without recourse.
Certifies that this application was completed by me, that all entries on it and information in it are true and complete to the best of my knowledge.
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Date of the agreement
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Remarks: (For office use only)
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Submit

ALCATRAZ OFFERS:

  • 2020 Dry Van & Reefer Trailers
  • 2020 Volvo 860 – Freightliner, International with APU & refrigeration …
  • The pay rate is up to .60 CPM
  • Dedicated Lane
  • Direct Deposit Weekly
  • Additional Stop pay $ 40.00 -$ 50.00
  • Bonus for Safety $ 250.00
  • 24/7 Dispatch
  • Passenger Insurance
  • Pet friendly

BENEFITS:

  • WE ARE built on a foundation of honesty
  • All miles paid ( deadhead + Loaded)
  • Averaging 2,500 – 3,200 miles per week
  • Steady year-round work
  • Solid support team
  • ELD friendly

Family Atmosphere

We know you by name, not a truck number. We respect you as an individual and as a member of the Alcatraz LLC family.

Recognition

If you got it, a truck driver hauled it. Drivers are a vital part of our company, let alone our economy. Be recognized for your contribution.

Well-Maintained

All equipment is well-maintained by our advanced maintenance department to ensure high performance and safe operation.