APPLY AS A DRIVER

Please Read Contract and SMS - Terms And Conditions.

Name

First Name

Last Name

Phone

(###)

###

####

Current Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Previous Addresses (03 years)

Write if applicable:

Previous Addresses (03 years)

Write if applicable:

Previous Addresses (03 years)

Write if applicable:

Position Applying For ?

Interested in work as?

Solo Driver

TEAM Driver

CDL State?

License Information

Licesnse Number, Class, State, Exp Date

License Information (List all other licenses held within prev three (03) years:

License Number, Class, State, Expiry Date:

License Information (List all other licenses held within prev three (03) years:

License Number, Class, State, Expiry Date:

License Information (List all other licenses held within prev three (03) years:

License Number, Class, State, Expiry Date:

Have you ever had driver's license denied, suspended, revoked or canceled by any state agency?

If yes, give state of issue and explanation of circumstances in below field.

If yes, give state of issue and explanation of circumstances

Leave empty if you select No above

Experience as a truck driver?

Less than 1 year

1-2 Years

2-5 Years

More than 5 Years

Driving Experience

Details of Type of Equipment (Truck, Trailer, Tank, Etc), Dates (From, To), Approx. Millage Driven.

List all traffic violation convictions for previous three years (Write NONE, if none)

Write complete details (Date, Location, Violation, Whether commercial or non commercial vehicle )

List all accidents for the previous three (03) years (Write NONE, If none)

Write details, date, nature of accident, fatalities, Injuries)

Employment History

List all employment for previous three (03) years, All driving job for previous 10 years, including any gaps between employment

Write complete details, Employer, period of employment(From, To), Supervisor, Address (City, state, ZIP), Telephone, Titles and Duties, Reason for leaving .

Use new box for next

Were you subject to Federal Motor Carrier Safety Regulations During this period?

Were you subject to 49 CFR part 40, controlled substances and alcohol testing during this period?

Write complete details, Employer, period of employment(From, To), Supervisor, Address (City, state, ZIP), Telephone, Titles and Duties, Reason for leaving .

Use new box for next

Were you subject to 49 CFR part 40, controlled substances and alcohol testing during this period?

Were you subject to Federal Motor Carrier Safety Regulations During this period?

Write complete details, Employer, period of employment(From, To), Supervisor, Address (City, state, ZIP), Telephone, Titles and Duties, Reason for leaving .

Use new box for next

Were you subject to Federal Motor Carrier Safety Regulations During this period?

Were you subject to 49 CFR part 40, controlled substances and alcohol testing during this period?

Write complete details, Employer, period of employment(From, To), Supervisor, Address (City, state, ZIP), Telephone, Titles and Duties, Reason for leaving .

Use new box for next

Were you subject to Federal Motor Carrier Safety Regulations During this period?

Were you subject to 49 CFR part 40, controlled substances and alcohol testing during this period?

Please read the SMS Terms & Conditions above. By checking this box, you confirm that you have read and accept the terms.

Please read the Contract above. By checking this box, you confirm that you have read and accept.

Certification

"By checking I certify that that this application was completed by my, and the at all the entries on it and information in it are true and complete to the best of my knowledge"

APPLY AS A DRIVER

Pamir Logistics INC