Driver Pre-Screening Questionnaire Class A Driver Pre Call Screening Questionnaire Please Complete Prior to our call. Thank youFirst Name Last Name Phone/Mobile Email If a Cell Phone - Do you allow us to text you? Yes No AddressAddress Line 1 Address Line 2 City State Zip Code Date of Birth Driving Experience Section How soon would you like to switch companies? ASAP 1-2 Weeks2-4 WeeksJust kicking tiresHow much of your experience has been OTR? Year and or Months How many states have you driven a Class A Vehicle in - last 12 months Is your OTR or Regional experience in the last 12 months? YesNo Overall Class A Driving Experience - Select -None Need CDL Have CDL Need Training 0-3 Months3-6 Months6-12 Months 1-2 Years 2-5 Years 5 Plus YearsEquipment Preference - Select -Van Tanker Flatbed Reefer Other For Flatbed Selection Only Have you hauled Coils prior? Yes No Do you have a TWIC Card? Yes No I would Like to Drive Solo Team Need partner Pre-Made Team OtherHome time Desired SelectLocal Home Daily (Limited Openings) Regional Regional DedicatedOTR Licence InformationLicense - Select -Regular Car License CDL Permit Class A CDL Class B CDL Class C CDL Have you attended a trucking school? - Select -Yes No If Yes is Selected - Enter Trucking School Name, City And State Do you have a graduation Certificate from the Trucking School? In your Possession or can request a copy? Yes I have oneYes I can request oneNo Do you have an automatic restriction on your CDL? - Select -Yes No Current And Past Companies Current Company Length of employment - Select -Training Only0-1 Months 1-2 Months3-4 Months4-6 Months 6-12 Months 1 Year 2 Years 3 Plus YearsPast Employer Length of employment - Select -Training Only0-1 Months 1-2 Months3-4 Months4-6 Months 6-12 Months 1 Year 2 Years 3 Plus YearsThird Employer Length of employment - Select -Training Only0-1 Months 1-2 Months3-4 Months4-6 Months 6-12 Months 1 Year 2 Years 3 Plus YearsBackground And Tickets Please give details as we have 40 plus carrier and could possibly place you with another company depending on background. Save us and you time with applying. Thank you Any accidents in CMV or personal vehicle in past 7 years ? - Select -Yes No If Yes Please Explain Any moving violations in past 5 years? - Select -Yes No If Yes Please Explain Have you ever failed a random or pre-employment drug test? Yes No If yes please explain in details and did you complete the SAP Program? Have you ever been terminated from a driving job? - Select -Yes No If yes please explain - was this your last employer and was it for safety? Can you pass a hair follicle drug test? - Select -Yes NoDo you have any felonies in your lifetime? If so for what and when? - Select -Yes No If Yes Please give Details and Dates Do you have any misdemeanors in your lifetime? If so for what and when? - Select -Yes No If Yes Please give Details and Dates Yes, I want to receive information and communications from Class A Jobs 411 concerning future opportunities or promotions. Yes Text Messages Would you like to receive text messages on future openings? Would you like to receive communication from Class A Jobs 411 via text message? By participating, you consent to receive text messages sent by an automatic telephone dialing system, which may contain recruiting/advertising messages. Consent to these terms is not a condition of being hired, contracted, or leased. You may opt out at any time by texting STOP to unsubscribe. You also agree that Class A Jobs 411's service provider receives in real time and logs your text messages with Class A Jobs 411. Yes Terms And ConditionsI have read and agree to the Terms and Conditions and Privacy Policy Official Disclosure Statement: I certify that I personally completed this application and that all of the information is true and correct to the best of my knowledge. Authorization to Release Records I authorize the carrier subscribers I have indicated on perfectcdljob.com to do a complete background investigation in accordance with state and federal laws. I authorize my previous employers to release any information requested by perfectcdljob.com carrier subscribers and hold them harmless of all liability from the release of said information. I hereby request and authorize to cause to be conducted, at any time, an investigation of my background for employment purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reflect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information. I have completed this application of my own free will and hold harmless of all liability all companies, agents and associated parties for the use of this application. Agree Yes General Information Storage Agreement I consent to having this website store my submitted information so they can respond to my inquirySubmit
