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Applications and Forms

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.

Please complete the form below.  Please also print out the following forms and mail or fax them to our office.

Form 301/413 : Request for Drug and Alcohol Testing History

Employee Drug and Alcohol Agreement

Previous Employer Reference Check Permission Statement

If you are unable to fill out the form below, you may print it and mail or fax it to us below.

 

Drivers Application for Employment

Position Applied for:
Full Name:
First Last Middle
List your addresses of residency for the past 3 years
Current
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
Previous 1
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
Previous 2
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
 
Date of Birth:
Do you have the legal right to work in the United States:
No Yes
Can you provide proof of age?
No Yes
Have you worked for Keypoint Carriers before?
No Yes
From:
To:
Reason for leaving:
Are you currently employed?
No Yes
If no, date of last employment:
Who referred you to Keypoint Carriers?
Rate of expected pay?
Is there any reason you may be unable to perform the functions of the job for which you are applying?
No Yes
Explain:
Employment History
All driver applications to drive in interstate commerce must provide the following information on all employers during the past 3 years.  List complete mailing address, street number, city, state and zip code.  Applicants to drive a commercial motor vehicle ( which includes vehicles having a GVWR of 25,001 lbs or more, vehicles designed to transport 15 of more passengers or any size vehicle used to transport hazardous materials in a quantity requiring placarding) in intrastate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operated such vehicle.
List Employment History starting with the most recent.
Employer 1
Name:
Contact Person:
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
Position
Pay Rate:
Reason For Leaving
Employer 2
Name:
Contact Person:
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
Position
Pay Rate:
Reason For Leaving
Employer 3
Name:
Contact Person:
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
Position
Pay Rate:
Reason For Leaving
Employer 4
Name:
Contact Person:
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
Position
Pay Rate:
Reason For Leaving
Employer 5
Name:
Contact Person:
Street:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
From:
To:
Position
Pay Rate:
Reason For Leaving
Accident Record
1. Date:
Fatalities:
Injuries:
Description:
2. Date:
Fatalities:
Injuries:
Description:
3. Date:
Fatalities:
Injuries:
Description:
4. Date:
Fatalities:
Injuries:
Description:
Traffic Convictions Report
1. Date:
Location:
Charge:
Penalty:
2. Date:
Location:
Charge:
Penalty:
3. Date:
Location:
Charge:
Penalty:
4. Date:
Location:
Charge:
Penalty:
 
Education
Highest Grade Completed:
Last School Attended:
Degree or Diploma Achieved:
 
Experience and Qualifications - Driver
Driver Licenses 1
State/Province:
License Number:
Type / Grade:
Expiration Date:
Driver Licenses 2
State/Province:
License Number:
Type / Grade:
Expiration Date:
Driver Licenses 3
State/Province:
License Number:
Type / Grade:
Expiration Date:
 
Have you ever been denied a license, permit or privilege?
No Yes
If yes, why?
Has any license, permit or privilege been suspended or revoked?
No Yes
If yes, why?
 
Driving Experience
Strait Truck:No Yes
Type /Equipment:
From
To
Approx. # of Miles Driven:
 
Tractor and Semi Trailer: No Yes
Type /Equipment:
From
To
Approx. # of Miles Driven:
 
Tractor - Two Trailers No Yes
Type /Equipment:
From
To