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Section 1: Online Application

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Section 2: Authorization to obtain background information

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ssn value should be numeric

 
 
 
YesNo
YesNo

QUALIFICATIONS

YesNo

YesNo

YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo

EXPERIENCE

Type of Vehicle Driven
Dates (From / To)
Approximate Mileage

DRIVER WORK HISTORY

  • Were you regulated under FMCSA rules?
    Yes No
    Were you subject to Drug and Alcohol testing?
    Yes No
  • Were you regulated under FMCSA rules?
    Yes No
    Were you subject to Drug and Alcohol testing?
    Yes No
  • Were you regulated under FMCSA rules?
    Yes No
    Were you subject to Drug and Alcohol testing?
    Yes No
  • Were you regulated under FMCSA rules?
    Yes No
    Were you subject to Drug and Alcohol testing?
    Yes No
  • Were you regulated under FMCSA rules?
    Yes No
    Were you subject to Drug and Alcohol testing?
    Yes No
  • Were you regulated under FMCSA rules?
    Yes No
    Were you subject to Drug and Alcohol testing?
    Yes No
     
    Date
    Type of Accident
    Fatalities
    Injuries
    Accident #1
    Accident #2
    Accident #3
    Location
    Date
    Charge
    Penalty

    For as long as I am operating for Hickory Transportation Services (HTS), I the undersigned, have authorized HTS and their affiliates/agents/representatives, to obtain the following information:

    • Past employment references (skills, behavior, experience, drug & alcohol tests) (391.23)
    • Driving record history
    • Criminal background records

    I understand that any information obtained as a result of this release will be provided to HTS for hiring eligibility based on DOT regulations under part 391 of 49 CFR.

    Please check this box if want to proceed.


    Thank You



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