Fleet Technician Application

Please Complete This Application to Be Considered.

*This Application is Completely Confidential. We Will Never Call Your Employer Without Your Verbal Permission.*

First Name *

Middle Name *

Last Name *

Email *

Phone *

Address *

State *

City/Town *

Zip Code *

Do you have a valid driver's license? *

Yes

No

Can you provide the necessary documentation to prove that you are a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States? *

Yes

No

If extended a job offer, are you willing to submit to a detailed background check and drug screen? *

Yes

No

Type of employment desired? *

Full Time

Part Time

Seasonal

Temporary

Date available for employment? *

Please indicate education or training which you believe qualifies you for the position you are applying *

Have you ever been discharged or forced to resign from any previous place of employment? *

Yes

No

Are you 21 years of age or older? *

Yes

No

For Motor Vehicle and Background Check purposes in order to determine your qualification for the position, please enter your Date of Birth: *

For Motor Vehicle and Background Check purposes in order to determine your qualification for the position, please enter your Social Security Number: *

This position is available in various locations. Please choose the location that interests you. *

De Soto

Iowa Grant

Prairie du Chien

Sparta

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. *

Yes

No

Include all licenses held for the past 3 years. Include State, License #, Type/Class, Endorsements & Expiration Date. *

Driving Experience. Please provide your driving experience for: Straight Truck, Tractor & Semi-Trailer, Tractor & 2 Trailers, Tractor & Tanker as well as any others. Include Type of Equipment, Date From, Date To & Approximate # of Miles (Total). *

Accident Record. Have you had any accidents within the past 3 years? *

Yes

No

If yes, please explain. Include Dates, Nature of Accident, # Fatalities, # Injuries & Chemical Spills (Y/N)

Traffic Convictions. Have you had any traffic convictions within the past 3 years? (Other than parking violations) *

Yes

No

If yes, please explain. Include Date Convicted (month/year), Violation, State of Violation & Penalty (forfeited bond, collateral and/or points).

Have you ever been denied a license, permit, or privilege to operate a motor vehicle? *

Yes

No

If yes, please explain.

Has any license, permit, or privilege ever been suspended or revoked? *

Yes

No

If yes, please explain why it was suspended or revoked.

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