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Need Help? Call us: KS
913-371-1000
| MO
816-254-8626
| Raymore
816-331-1550
| St Joe
816-305-5570
Need Help? Call us:
KS
913-371-1000
MO
816-254-8626
Raymore
816-331-1550
St Joe
816-305-5570
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Driver Application
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Driver Application
admin
2025-01-02T19:46:15+00:00
Click Here to Download a Printable Application
Or, Apply Online Below
Please Read Carefully, by Applying you Understand and Accept This Information
(Required)
I certify that the information contained in this application and its supporting documents are accurate and complete. I understand and agree that failure to fully complete the application, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize All City Yow to investigate, without liability, all statements contained in this application and inquiries in connection with this employment application. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that employees of All City Tow serve at-will, and the employment relationship may be terminated at any time by either part, for any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States and to comply with company policies and applicable regulations. All City Tow is an Equal Opportunity Employer, meaning employment decisions are made without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or other characteristics protected by applicable law.
I agree to the above
Name
(Required)
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Middle
Last
Phone
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Email
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Date of Application
(Required)
MM slash DD slash YYYY
Date Available for Work
(Required)
MM slash DD slash YYYY
Position Applied For
Do you have the legal right to work in the United States?
(Required)
Yes
No
Previous 3 Years of Residency
(Required)
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Street Address
City
State
Zip Code
# of Years at Address
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Current Mailing Address
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Street Address
Address Line 2
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License Information
No person who operates a commercial motor vehicle shall at any time have more than one driver's license (19 CFR 383.21). I certify that do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years.
State
License #
Type/Class
Endorsements
Expiration Date
Previously Held Licenses
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State
License #
Type/Class
Endorsements
Expiration Date
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Have you had an accident in the past 3 years?
(Required)
Yes
No
Accident Record for the Past 3 Years
(Required)
Click the + icon to add more incidents
Date
Nature of Accident (Head-on, rear-end, upset, etc.)
# of Fatalities
# of Injuries
Chemical Spills (Y/N)
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Have you had a traffic conviction or forfeiture in the past 3 years? (Other than parking violations)
(Required)
Yes
No
Traffic Convictions and Forfeitures for the Past 3 Years
(Required)
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Date Convicted (Month/Year)
Violation
State of Violation
Penalty (Forfeited Bond, collateral, and/or points)
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Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
(Required)
Yes
No
Please Explain
(Required)
Has any license, permit or privilege ever been suspended or revoked?
(Required)
Yes
No
Please Explain
(Required)
Current (Most Recent) Employer
Name
Phone
Address
Position Held
Reason for Leaving
While employed here, were you subject to the Federal Motor Carrier Safety Regulations?
Yes
No
Was the job designated as a safet-sensitive function in any Department of Transportation-regulated mode subject ot alcohol and controlled substances testing as required by 49 CFR, part 40?
Yes
No
Previous Employers
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Name
Phone
Address
Position Held
Reason for Leaving
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Education
(Required)
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School Level (High School, College, etc.)
Name & Location
Course of Study
Years completed
Graduate (Y/N)
Details
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Other Qualifications
Please List any other qualifications that you have and which you believe should be considered.
To be read and signed by applicant
(Required)
I authorize you to make Investigations (including contacting current and prior employers( into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. 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 also understand that I am required to abide by all rules and regulations of the Company.
I understand that the information I provideregarding my current and/or prior 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. 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 resend the corrected information to the prospective empoyer; 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.
This cerifies 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. Note: A motor carrier may require and applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.
I have read and agree to the above
Applicant Signature
(Required)
Applicant Name
(Required)
First
Last
Date
(Required)
MM slash DD slash YYYY
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