Application For Employment

We are an equal opportunity employer, dedicated to a policy of non-discrimination. Employment is based upon qualification, without regard to race, sex, religion, marital status, familial status, sexual orientation, color, age, national origin, veteran's status, disability, status with regard to public assistance, and any other status protected by law.
Please complete all information even if included in your resume.

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Personal Information

Full Name (First, Middle, Last):*Please state age if under 18:
Social Security Number:*Email:*
Cell Phone:Home Phone:
Complete Current Address:*

If at the above residence for less than 3 years, list all residences for the past 3 years below

Previous Address:
+ Add Previous Address
Who referred you?
Rate of pay expected?When are you available for employment?*
Type of work expected?*
Are you authorized to work in the United States?*

* Proof of identity and employment eligibility will be required upon beginning employment.

Education

High School or GED

School Name / Location:Certification / Degree Earned:Number of Years:

College

School Name / Location:Certification / Degree Earned:Number of Years:

Trade or Technical School

School Name / Location:Certification / Degree Earned:Number of Years:

Military

Service Branch / Location:Certifications Earned:Number of Years:

Driver's License Information

No person who operates a commercial motor vehicle shall at any time have more than one driver’s license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years; attach additional sheets if needed

License #:*State:*
Type/Class:*Endorsements:Expiration Date:*
+ Add Previous License

Driving Experience

Class of Equipment:Type of Equipment (Van, Tank, Flatbed, etc):
Date From:Date To:Estimated Total Miles:
+ Add Vehicles/Equipment

Accident Record For The Past 3 Years (if any)

Date:# of Injuries:# of Fatalities:
Nature of Accident (head-on, rear-end, etc.):Chemical Spill?
+ Add Accident

Traffic Convictions for the Past 3 Years (other than parking violations if any)

Date Convicted:Violation:
State of Violation:Pentalty:
+ Add Conviction
Have you ever been denied a license, permit or privilege to operate a motor vehicle?*
Please Explain:*
Has any license, permit or privilege ever been suspended or revoked?*
Please Explain:*

Employment History / Work Experience

The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained. Start with the last or current position, including any military experience, and work backwards (attach separate sheets if necessary). You are required to list the complete mailing address, including street number, city, state, zip; and complete all other information.

List Your 3 Most Recent Positions

Employer Name:Address:
Date Started:Starting Earnings:Starting Position:
Date Ended:Ending Earnings:Ending Position:
Supervisor Name:Reason For Leaving:
Brief Description of Responsibilities:
While employed here, were you subject to the Federal Motor Carrier Safety Regulations?
Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?
+ Add Recent Position

Professional References

Name:Phone Number:
Name:Phone Number:
Name:Phone Number:

APPLICANT - Please Read Carefully and Sign

I affirm that the information provided is true and complete and that I have not withheld any fact(s). Any misrepresentation, falsification, omission, or derogatory information that is discovered may prevent my being hired, or if hired, may subject me to disciplinary action, up to and including immediate employment dismissal.

I authorize YTS Companies, LLC. or its agents to conduct an investigation and verification of all statements and information contained in this application that YTS Companies, LLC. may deem relevant to evaluating my qualifications for employment. I authorize all my previous employers or other persons having information concerning me or my record of employment to report such information to YTS Companies, LLC. I release each such person, YTS Companies, LLC. and its agents from all claims and liability whatsoever arising out of such an investigation and disclosure of my background. YTS Companies, LLC. will seek to keep all such information confidential except where such information is required to be released by law.

I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my previous drug and alcohol test results and safety performance history as required by 49 CFR 391.23. I understand that I have the right to: review information provided by current/previous employers; have errors in the information corrected by previous employers, and for those previous employers to resend the corrected information to the prospective employer; and have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

Upon receiving a conditional offer of employment, I agree to submit to a physical examination and testing for illegal drugs by a doctor or facility designated by and at the expense of YTS Companies, LLC. I also agree to submit to testing for alcohol and/or illegal drugs if requested at subsequent intervals as the employer may direct during the course of my employment. I understand that refusal to submit to such testing may result in my dismissal. I agree to permit YTS Companies, LLC. to collect urine, blood, saliva, hair and/or other samples from me to conduct testing to determine the presence or use of alcohol and/or drugs. Further, I agree to the release of drug test results and other relevant medical information to authorized YTS Companies, LLC. representatives. I also agree that my employment with YTS Companies, LLC.is contingent upon passing such testing as determined by YTS Companies, LLC.

I understand that this is an application for employment and that no employment contract is being offered. I also understand that, if offered employment, I will be an at-will employee of YTS Companies, LLC. which means that my employment can be terminated at any time for any reason not prohibited by law, with or without cause or notice, at the option of either YTS Companies, LLC. or myself. No representative of YTS Companies, LLC. has any authority to make any representation to the contrary.

I have read, understand, and agree to the above.

Electronic Signature:*Date Signed:*

Please complete the visual confirmation*