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Online Driver Application
Elite Trucking Inc

Date of Application:
First Name:
 Last Name:
Current Address:
State:
Zip Code:
City:
Home Phone #
Cell Phone #
Email Address:
Date of Application:
Name:
Current Address:
Zip Code:
State:
City:
Home phone:
Cell Phone:
Email Address:
Date of Birth:
Social Security #
yes
no
Do you have the legal right to work in the U.S.
Can you provide proof of age?
Who referred you?
All applicants to drive a commercial motor vehicle in interstate commerce must
provide the following information on all employers during the preceding 3 years.  
List complete mailing address, street number, city, state, zipcode, and phone #
Employer name:
Dates employed:
Address:
City:
State:
Zip Code:
Phone:
Contact person:
Reason for Leaving:
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Dates employed:
Employer name:
Address:
State:
City:
Zip Code:
Phone:
Contact person:
Reason for Leaving:
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Employer Name:
Dates employed:
Address
:
City:
State:
 Zip Code:
Contact person:
Phone:
Reason for Leaving:
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Accident Record:
Nature of Accident:
Date:
Fatalities:
 Injuries:
Traffic Convictions:
Date:
Location:
Charge:
Location:
Charge:
Date:
Drivers License Information:
State:
License Number:
Type:
Expiration date:
Driving Experience
Class of Equipment:
 Dates:  From - To
Aprrox.  # of miles:
Straight Truck:
Tractor & Semi Trailer:
5th Wheel RV:
Other:
List states operated in for the last 5 years:
List special courses or training that will
help you as a driver:
Education
Last grade completed:
This certifies that this application was completed by me, and that all entries on it and
information in it are true and complete to the best of my knowledge. I authorize you to
make such investigations and inquiries of my personal, employment, financial or
medical history and other related matters as may be necessary in arriving at an
employment decision. In the event of my employment, I understand that false or
misleading information given in my application or interviews may result in discharge. I
also understand that I am required to abide by all rules and regulations of the company.
Initial here:
I hereby authorize you to release the following information to Elite Trucking Inc. for
purposes of investigation as required by Sections 391.23 and 391.25 of the Federal
Motor Carrier Safety Regulations.  You are released from any and all liability which may
result from furnishing such information.
Initial here: