Drivers Wanted; Carlen Transport, Maine's finest flatbed, carrier is a Maine based long haul trucking company specializing in hauling flatbed freight throughout all 48 states and Eastern Canada.

Driver Employment Application

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This application will be presented is several sections depending on your answers. Do not exit during the application process or you will have to begin the process again. When you have completed the application and have submitted it, you will be directed to an acceptance page with your application number on it. Be sure to make note of this number.

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disability.

^{Position Applied For}

^{Social Security No.}

^{Phone No.}

^{Email Address}

^{LAST NAME}

^{FIRST NAME}

^{MIDDLE NAME}

List your addresses of residency for the past 3 years.

Current Address:

^ADDRESS	^CITY	^STATE	^ZIP	^{HOW LONG?}
Previous Address(es):
^ADDRESS	^CITY	^STATE	^ZIP	^{HOW LONG?}
^ADDRESS	^CITY	^STATE	^ZIP	^{HOW LONG?}
^ADDRESS	^CITY	^STATE	^ZIP	^{HOW LONG?}

Do you have the legal right to work in the United States? YES NO

^{DATE OF BIRTH (MM-DD-YYYY)}

Can you provide proof of age? YES NO

Have you worked for this company before? YES NO

If so, where?

Dates:
^{FROM (MM-DD-YYYY)}

^{TO (MM-DD-YYYY)}

^{RATE OF PAY}

^POSITION

Reason for leaving?

Are you now employed?
YES NO

If not, how long since leaving last employment?

Who referred you?

Rate of pay expected

Is there any reason you might be unable to perform the functions of the job for which you have applied? YES NO

If yes, explain if you wish.

EMPLOYMENT HISTORY

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code.

Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle.
(NOTE: List employers in reverse order starting with the most recent.)

* Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

EMPLOYER

DATE

^{EMPLOYER NAME}

^{FROM (MM-YYYY)}

^{TO (MM-YYYY)}

^ADDRESS

^{POSITION HELD}

^CITY

^STATE

^ZIP

^SALARY/WAGE

^PHONE

^CONTACT

^{REASON FOR LEAVING}

EMPLOYER

DATE

^{EMPLOYER NAME}

^{FROM (MM-YYYY)}

^{TO (MM-YYYY)}

^ADDRESS

^{POSITION HELD}

^CITY

^STATE

^ZIP

^SALARY/WAGE

^PHONE

^CONTACT

^{REASON FOR LEAVING}

EMPLOYER

DATE

^{EMPLOYER NAME}

^{FROM (MM-YYYY)}

^{TO (MM-YYYY)}

^ADDRESS

^{POSITION HELD}

^CITY

^STATE

^ZIP

^SALARY/WAGE

^PHONE

^CONTACT

^{REASON FOR LEAVING}

EMPLOYER

DATE

^{EMPLOYER NAME}

^{FROM (MM-YYYY)}

^{TO (MM-YYYY)}

^ADDRESS

^{POSITION HELD}

^CITY

^STATE

^ZIP

^SALARY/WAGE

^PHONE

^CONTACT

^{REASON FOR LEAVING}

EMPLOYER

DATE

^{EMPLOYER NAME}

^{FROM (MM-YYYY)}

^{TO (MM-YYYY)}

^ADDRESS

^{POSITION HELD}

^CITY

^STATE

^ZIP

^SALARY/WAGE

^PHONE

^CONTACT

^{REASON FOR LEAVING}

ACCIDENT RECORD

All driver applicants must report accident information for the past 3 years. Start with the most recent and work backward providing the date, nature of the accident (Head-on, rear-end, upset, etc.), number of fatalities and number of injuries. If you haven't had any write NONE in the first "nature of accident" box.

^{Date (DD-MM-YYYY)}	^{Nature of Accident}	^Fatalities	^Injuries
^{Date (DD-MM-YYYY)}	^{Nature of Accident}	^Fatalities	^Injuries
^{Date (DD-MM-YYYY)}	^{Nature of Accident}	^Fatalities	^Injuries
^{Date (DD-MM-YYYY)}	^{Nature of Accident}	^Fatalities	^Injuries
^{Date (DD-MM-YYYY)}	^{Nature of Accident}	^Fatalities	^Injuries

TRAFFIC CONVICTIONS

All driver applicants must report traffic convictions received in the past 3 years. Start with the most recent and work backward providing the location, date, charge and penalty. If you haven't had any write NONE in the first "location" box.

^Location	^{Date (DD-MM-YYYY)}	^Charge	^Penalty
^Location	^{Date (DD-MM-YYYY)}	^Charge	^Penalty
^Location	^{Date (DD-MM-YYYY)}	^Charge	^Penalty
^Location	^{Date (DD-MM-YYYY)}	^Charge	^Penalty
^Location	^{Date (DD-MM-YYYY)}	^Charge	^Penalty

EDUCATION

Select the highest grade completed:

^{Last School Attended}

^City

EXPERIENCE AND QUALIFICATIONS - DRIVER

Drivers Licenses

^State	^{License No.}	^Type	^{Expiration Date}
^State	^{License No.}	^Type	^{Expiration Date}
^State	^{License No.}	^Type	^{Expiration Date}
^State	^{License No.}	^Type	^{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
If the answer to either of the latter two questions is yes, give the details below. You may be required to provide a written statement as well.

DRIVING EXPERIENCE

Fill in the data for each class of equipment listed. If no experience with a class, write "NONE".

CLASS OF EQUIPMENT	TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC)	DATES		APPROX. NO OF MILES (TOTAL)
Straight Truck	^{Type of Equipment}	^{From (DD-MM-YYYY)}	^{To (DD-MM-YYYY)}	^Miles
Tractor & Semi Trailer	^{Type of Equipment}	^{From (DD-MM-YYYY)}	^{To (DD-MM-YYYY)}	^Miles
Tractor - Two Trailers	^{Type of Equipment}	^{From (DD-MM-YYYY)}	^{To (DD-MM-YYYY)}	^Miles
Motor Coach - School Bus	^{Type of Equipment}	^{From (DD-MM-YYYY)}	^{To (DD-MM-YYYY)}	^Miles
^Other	^{Type of Equipment}	^{From (DD-MM-YYYY)}	^{To (DD-MM-YYYY)}	^Miles

List states operated on for last five years:

Show special courses that will help you as a driver:

Which safe driving awards to you hold and from whom?

Show any trucking, transportation or other experience that may help you in your work for this company.

List courses and training other than shown elsewhere in this application.

List special equipment or technical materials you can work with (other than those already shown).

TO BE READ AND COMPLETED BY APPLICANT

Mother's Maiden Name:

CHECKING THIS BOX, COMPLETING MY MOTHER'S MAIDEN NAME AND SUBMITTING THIS FORM 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.

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have a right to:

Review information provided by previous employers;

Have errors in the information corrected by previous employers and for those previous employers to re-send 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.

800-959-4507 ~ 207-990-4507
Info1@CarlenTransport.com