Careers | Deep South Freight

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Instructions

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Your Information

Street Address

How long have you lived at this address?

Addresses you resided in the last 3 years

Street Address

How long have you lived at this address?

Street Address

How long have you lived at this address?

Street Address

How long have you lived at this address?

Emergency Contact

Street Address

Additional Information

How did you hear about us?

Please list where you heard about us.

Do you have 2 years of tractor trailer experience?

Previous Employers

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Position

Reason for leaving

At this contract/employer, were you subject to Federal Motor Carrier Safety Regulations?

At this contract/employer, was your position designated as a safety-sensitive function in any DOT regulation and subject to alcohol and controlled substance testing required by 49 CFR, Part 40?

Education

Last School Attended

Driver License Record

List all licenses you have held in the last 3 years.

Has any license, permit, or privilege to operate a motor vehicle that has been issued to you ever been denied, revoked or suspended?

If your answer is yes, explain the facts and circumstances involving such action.

Previous Driving Experience

Have you been leased as a driver or owner/operator by any other motor carriers prior to the date of this information sheet?

If so, how long (years) did you operate:

Accident Record

List all accidents in which you were involved as a driver during the preceding three (3) years.

Traffic Violation Record

List all violations of motor vehicle law or ordinances (other than parking) of which you were convicted or forfeited bond or collateral during the preceding three (3) years.

Substance Abuse Information

In the last three years, have you tested positive, or refused to test, on any pre-employment drug or alcohol test administrated by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules?

By clicking the Agree & Submit button, I certify that I have read, understand and agree to comply with Deep South Freight Statement of Policy on Drug Abuse. By entering into a lease with Deep South Freight, I also consent to submit to urine testing for drugs and controlled substances and I agree to comply with all of the requirements of Deep South Freight, the Federal Motor Carrier Safety Regulations and any federal, state or local laws and rules governing the use of drugs and controlled substances. I understand that my failure to honor the terms of this agreement will be grounds for termination of my lease, or loss of consideration of my application for lease with Deep South Freight.

Furthermore, I certify that I completed the information in this electronic form and that all entries and information in it are true and complete to the best of my knowledge. I authorize Deep South Freight to make such investigations and inquiries of my personal, employment, state motor vehicle record, financial history, medical history, and other related matters as may be necessary in arriving at a leasing decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of leasing has been extended.) 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 answers. In the event of leasing, I understand that false or misleading information given in my answers or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the company.

I hereby release prior employers/contractees and the individual supplying the applicable information from any and all liability resulting from the release of any information regarding my safety performance history as required by 49 CFR 391.23(d) and (e) and I understand the rights provided for in 49 CFR 391.23(i).

In accordance with FMCSR 391.21(d), as an applicant, I understand I am afforded the following rights regarding investigative information that will be requested and provided by my previous employer(s). These rights are stated below and by electronically submitting this document I confirm receipt and understanding of these rights per 391.23(i).

(i)(1)(i) The right to review information provided by previous employers;

(i)(1)(ii) The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective motor carrier;

(i)(1)(iii) The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

(i)(2) Drivers who have previous Department of Transportation regulated employment history in the preceding three years, and wish to review previous employer-provided investigative information must submit a written request to the prospective motor carrier, which may be done at any time, including when applying, or as late as 30 days after being employed or being notified of denial of qualification. The prospective motor carrier must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective motor carrier has not yet received the requested information from the previous employer(s), then the five-business day's deadline will begin when the prospective motor carrier receives the requested safety performance history information. If the driver has not arranged to pick up or receive the requested records within thirty (30) days of the prospective motor carrier making them available, the prospective motor carrier may consider the driver to have waived his/her request to review the records.

I have read and agree to the terms stated in this agreement.