Pre-Qualification Driver Questionnaire

Which facility are you applying for? *

How many years of experience do you have pulling 53' trailers? *

How many years of experience do you have pulling Double trailers? *

Have you had any accidents in the last three years? *

0 1 2 3 +

Have you had any moving violations in the last three years? *

0 1 2 3

Do you have a felony criminal background? *

Yes No

Can you communicate with dispatch? *

Yes No

Have you been employed as a truck driver in the past three years? *

Yes No

Are you currently employed? *

Yes No

Why did you leave your last job? *

Have you ever had a defensive driving course? *

Yes No

Can you fill out a log? *

Yes No

Can you fill out a DVIR? *

Yes No

Can you do a proper vehicle inspection? *

Yes No

Can you work variable shifts as needed? Pick-Up, Line, Delivery? *

Yes No

Can you provide copy of 10 year MVR? *

Yes No

We do not offer sick pay, are you still interested? *

Yes No

There is no vacation pay, but we do offer bonus pay. Are you still interested? *

Yes No

What is the best time for a face to face interview? *

AM PM

Name * First Last

Address * First Address Second Address City Postal/ZIP Code State/province/Region Country

Phone Number (HOME) *

( ### ) ### - ####

Phone Number (Cell) *

( ### ) ### - ####

E-mail

Enter your email: * A link to the form will be sent to you via email. You can go back to form completion anytime Incorrect Email

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