Driver App NM

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Driver Application for New Mexico

Driver Application NM

Use this to apply for a Driver job Please answer all questions

Date*

Date of Application
Name*
First Middle Last
Email address*
Phone*
Emergency Phone*
Age*
Please enter a value between 18 and 90.
Date of Birth*
Social Security #*
Physical Exam Expiration Date*
Are you a Veteran?
- Yes
- No
How did you hear about us?*
Current and previous addresses
Your current and three years previous addresses
Current Address*
Street Address Address Line 2 City State ZIP Code
Previous Address
Street Address Address Line 2 City State ZIP Code
Previous Address
Street Address Address Line 2 City State ZIP Code
Previous Address
Street Address Address Line 2 City State ZIP Code
Education and Employment History
Select your highest level of education*
- High School
- Some College
- Associate Degree
- Bachelor's Degree
- Graduate or Professional Degree
Education Comments
Have you ever worked for D&A McRae before?*
- Yes
- No
If yes, Give dates. From
Until
Reason for leaving
Current or Previous Employer
Provide a complete record of all employment for the past 10 years, including any unemployment or self employment, and all commercial driving experience for the past 10 years
*The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone who operates a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) has a GVWR or weighs 10,001 pounds or more, (2) is designed or used to transport nine or more passengers, or (3) is of any size, used to transport hazardous materials in a quantity requiring placarding
Start Date*
End Date
Company Name*
Position Held*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Reason for Leaving*
Were you subject to the FMCSRs* while employed here?*
- Yes
- No
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?*
- Yes
- No
Previous Employer 2
Start Date
End Date
Company Name
Position Held
Address
Street Address Address Line 2 City State ZIP Code
Phone
Reason for Leaving
Were you subject to the FMCSRs* while employed here?
- Yes
- No
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?
- Yes
- No
Previous Employer 3
Start Date
End Date
Company Name
Position Held
Address
Street Address Address Line 2 City State ZIP Code
Phone
Reason for Leaving
Were you subject to the FMCSRs* while employed here?
- Yes
- No
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?
- Yes
- No
Previous Employer 4
Start Date
End Date
Company Name
Position Held
Address
Street Address Address Line 2 City State ZIP Code
Phone
Reason for Leaving
Were you subject to the FMCSRs* while employed here?
- Yes
- No
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?
- Yes
- No
Driving Experience
Straight Truck*
From Until Approximate number of Total Miles
Tractor and Semi-trailor*
From Until Approximate number of Total Miles
Tractor and two trailers*
From Until Approximate number of Total Miles
Tractor and three trailers (triples)*
From Until Approximate number of Total Miles
Other
Type From Until Approximate number of Total Miles
List all states you have operated in the last 5 years:*
List any special courses and/or training you have completed (PTD/DDC, haz Mat, etc.)*
List any safe driving awards you hold and from whom
Accident Record for the past three years
Date of accident Nature of Accident Location of Accident # of Fatalities # of People Injured
Traffic Convictions and Forfeitures for the past three years
Date Location Charge Penalty
Driver's License (list each driver's license held in the past three years
State License # Type Endorsements Expiration Date
Have you ever been denied a license, permit or privilege to operate a motor vehicle?*
- Yes
- No
Has any license, permit, or privilege ever been suspended or revoked?*
- Yes
- No
Is there any reason you might be unable to perform the functions of the job for which you applied?*
- Yes
- No
If you answered yes to any of the above four questions above, provide details
Personal References
List three persons for references, other than family members, who may have knowledge of your safety habits.
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Phone*
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
To Be Read and Agreed Upon by Applicant
It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty. It is agreed and understood that the motor carrier (D&A McRae) or his agents may investigate the applicant’s background to obtain any and all information of concern to applicant’s record, whether same is of record or not, and applicant releases employers and person named herein from 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 my application file. It is agreed and understood that this Application 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 disqualified without recourse. This certifies 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 my knowledge.
Signature*
By enterning you name below you agree to the terms above
Date Signed*

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Driver App NM

Driver Application for New Mexico

Driver Application NM

Current and previous addresses

Education and Employment History

Current or Previous Employer

Provide a complete record of all employment for the past 10 years, including any unemployment or self employment, and all commercial driving experience for the past 10 years

Previous Employer 2

Previous Employer 3

Previous Employer 4

Driving Experience

Personal References

To Be Read and Agreed Upon by Applicant