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301-330-1170
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We are hiring! Please use the online application to tell us abut yourself.
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Employment Application
Name
*
First
Last
*
Last
Email
*
Home Phone
Mobile Phone
Address
*
Address
Address
Address
City
City
State/Province
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State/Province
Zip/Postal
Zip/Postal
How long have you lived here?
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Can you legally work in the US?
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Are you currently employed?
*
Yes, Full Time
Yes, Part Time
No
Position you are applying for:
Date you can start:
Drivers License Number:
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Date License Expires:
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Accident Record for the Past 3 Years (Other than Parking Violations)
Traffic Convictions and Forfeitures for the Past 3 Years (Other than Parking Violations)
Attach Driving Record
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Driving Experience - Check all that apply
Tow Truck Light Duty
Tow Truck Heavy Duty
Tractor
Wide Load
Van
Tank
Flat Bed
New Option
Experience Location (check all that apply)
Local
East Coast
National
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Yes
No
Has any license or privilege ever been suspended or revoked?
Yes
No
Have you ever tested positive or refused a pre-employment drug or alcohol test?
Yes
No
Previous Employment
Employer 1
Phone
Salary
Reason for Leaving
Employer 2
Phone
Salary
Reason for Leaving
Information and Consent for Background Check
Prior Address 1
Prior Address 1
Prior Address 1
Prior Address 1
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
From
To
Prior Address 2
Prior Address 2
Prior Address 2
Prior Address 2
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
From
To
Prior Address 3
Prior Address 3
Prior Address 3
Prior Address 3
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
From
To
Full Name As Above
*
Date of Birth
*
Social Security Number
*
Authorize
I have read and understand this Disclosure and Authorization form and the attached summary of rights under the Fair Credit Reporting Act. By my signature below, I consent to the release of consumer report s and investigative consumer reports prepared by a consumer reporting agency, such as Hir.eRight Inc. to the company and its designated representatives and agents. I understand that if the company hires me, my consent will apply, and the Company may obtain reports throughout my employment. I also understand that information contained in my job application or otherwise disclosed by me before or during my employment. If any, may be used for the purpose of obtaining consumer reports and/or investigative consumer reports. By my signature below, I authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal, state, and local), motor vehicles records agencies, my past or present employers, the military, and other individuals and sources to furnish any and all information on me that is requested by the consumer reporting agency. By my signature below, I certify the information provided on this form is true and correct. I agree that this Disclosure and Authorization form in original, faxed, photocopied or electronic (including electronically signed) form, will be valid for any reports that may be requested by or on my behalf of the Company . California, Minnesota or Oklahoma applicants only - You will be provided with a free copy of any consumer reports or investigative consumer reports obtained on you if you check the box below.
Provide a Copy of My Report
Yes
Signature
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