Truck Drivers

Individuals seeking positions as truck drivers must complete the following application:

DOT Driver Application

Step 1 of 12

Your Personal Information

The policy of BDS Tire Recycling, Inc. is to provide equal employment opportunities to all applicants without regard to race, color, religion, sex, sexual orientation, age, national origin, disability and/or veteran status. Every question must be answered in order for application to be considered. If needed, you may attach additional pages of information to this application.

Company

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Name(Required)

First Middle Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How Many Years Have You Lived Here?

Previous address, if address has changed during the past 3 years

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth

MM slash DD slash YYYY

Today's Date

MM slash DD slash YYYY

Social Security Number

Your Primary Phone(Required)

Your Secondary Phone

Your Email Address(Required)

Enter Email Confirm Email

License Information

State

License Number

Type

Expiration Date

Section 383.21 FMCSR

Section 383.21 FMCSR states “No person who operates a commercial motor vehicle shall at any time have more than one driver’s license”. I certify that I do not have more than one motor vehicle license, the information for which is listed above.

I agree

Driving Experience

Click the “+” button to add all classes of equipment you have worked with, including Straight Truck, Tractor and Semi-Trailer, Tractor – Two Trailers, Other, etc.

Class of Equipment

Type of Equipment (Van, Tank, Flat, Etc.)

Dates (To – From)

Approximate Number of Miles (Total)

Accident Record

Please indicate any accidents you have had in the past three years, whether you were at fault or not. Click the “+” button to add incidents.

Date

Nature of Accident (Head-On, Rear-End, Upset, Etc.)

Number of Fatalities

Number of Injuries

Chemical Spills (Yes / No)

Traffic Convictions / Forfeitures

Please indicate any traffic convictions and/or forfeitures you have had in the past three years. Do not include parking violations. Click the “+” button to add incidents.

Date Convicted

Violation

State of Violation Location

Penalty (forfeited bond, collateral and /or points)

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

Yes

If yes, please explain:

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

Yes

If yes, please explain:

Last Employer

Applicants that desire to drive in intrastate/interstate commerce must provide the following information on all employers during the previous three years. You must give the same information for all employers you have driven a commercial motor vehicle for the seven years prior to the initial three years (total of ten years employment record).

Dates

Employer Name and Address

Employer Telephone Number

Position

Reason For Leaving

Salary

ANY GAPS IN EMPLOYMENT AND/OR UNEMPLOYMENT MUST BE EXPLAINED. INCLUDE DATES (MONTH/YEAR) AND REASON.

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?(Required)

Yes

Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40?(Required)

Yes

Second Last Employer

Dates

Employer Name and Address

Employer Telephone Number

Position

Reason For Leaving

Salary

ANY GAPS IN EMPLOYMENT AND/OR UNEMPLOYMENT MUST BE EXPLAINED. INCLUDE DATES (MONTH/YEAR) AND REASON.

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?(Required)

Yes

Third Last Employer

Dates

Employer Name and Address

Employer Telephone Number

Position

Reason For Leaving

Salary

ANY GAPS IN EMPLOYMENT AND/OR UNEMPLOYMENT MUST BE EXPLAINED. INCLUDE DATES (MONTH/YEAR) AND REASON.

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?(Required)

Yes

Upload Your Resume (Optional)

If you woud like, please upload your resume in .pdf, .doc or .docx format.

Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

To Be Read and Signed by Applicant(Required)

I authorize you to make sure investigations and inquiries to 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 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 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.”

BY CHECKING THE AGREE BOX BELOW, I ATTEST THAT I FULLY UNDERSTAND AND ACCEPT ALL TERMS AND CONDITIONS OF THE PRECEDING STATEMENT:

I agree to the terms and conditions.

Date

MM slash DD slash YYYY

Name

Submit Application

By entering the date and typing in your name above, certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. This application will be given every consideration, but its receipt does not imply that the applicant will be employed. A motor carrier may require an applicant to provide information in addition to the information required by the Federal Motor Carrier Safety Regulations.

For more information regarding employment at BDS Tire Recycling, Inc., please contact us, and we will be happy to answer any questions you may have.

Phone: 207-278-3833