Employment Application – Eagle Eye Truck

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Position(s) Applied for *

First Name *

Middle Name

Last Name *

Addresses of residency for the past 3 years

Current Address

Street *

City *

Zip Code *

Phone *

How Long *

Previous Address

Street

City

Zip Code

How Long

Do you have the legal right to work in the United States? *

Date of Birth

Can you provide proof of age?

(required for commercial drivers)

Have you worked for this company before? *

Where?

Date From

Date To

Rate of Pay

Position

Reason for Leaving

Are you employed? *

If not, how long since leaving last employment?

Who referred you?

Rate of Pay expected

Have you ever been bonded

Name of bonding company

(Answer only if a job requirement)

Is there any reason you might be unable to perform the functions of the job for which you have applied? *

If yes, explain if you wish

REQUEST FOR CHECK OF DRIVING RECORD

By checking below, you authorize the release of the following information to Eagle Eye Truck Lines LLC for purposes of investigation as required by Sections 391.23 and 391.25 of the Federal Motor Carrier Regulations . You are released from any and all liability which may result from furnishing such information.

Note: The requester must read and sign the following in the event the driving record is requested using a consumer reporting agency.

In accordance with the provisions of Sections 604 and 607 of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Reform Act of 1996 (Title II, Subtitle D, Chapter 1, of Public Law 104-208), I hereby certify the following:

The consumer (applicant) has authorized in writing the procurement of this report;
The consumer (applicant) has been informed in a separate written disclosure that a consumer report may be obtained for employment purposes;
The information requested below will be used for a “permissible purpose” (i.e., information for employment purposes) and will be used for no other purpose;
The information being obtained will not be used in violation of any federal or state equal opportunity law or regulation; and
Before taking an adverse action based in whole or in part on the report the consumer (applicant) will receive a copy of the requested report and the summary of consumer rights as provided with the report by the consumer reporting agency.

I hereby certify that this report request and the above applicant’s release notice meet the definition of “permissible uses” of state motor vehicle records under the provisions of the Driver’s Privacy Protection Act of 1994 ( Public Law 103-322, Title XXX, Section 300002(a)).

I authorize the above *

Motor Vehicle Driver’s CERTIFICATION OF COMPLIANCE WITH DRIVER LICENSE REQUIREMENTS

MOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to ever driver who operates in intrastate, interstate, or foreign commerce and operates a vehicle weighing or rated at 26,001 pounds or more, can transport more than 15 people. Or transports hazardous materials that require placarding.

The requirements in Part 391 apply to ever driver who operates in interstate commerce and operates a vehicle weighing or rated at 10,001 pounds or more, can transport more than 15 people (or more than 8 people when there is direct compensation), or transports hazardous materials that require placarding.

DRIVER REQUIREMETNS: Parts 383 and 391 of the Federal Motor Carrier Safety Regulations contain certain driver licensing requirements that you as a driver must comply with, including the following:

POSSESS ONLY ONE LICENSE: You, as a commercial vehicle driver, may not possess more than one motor vehicle operator’s license.
NOTIFICATION OF LICENSE SUSPENSION, REVOCATION OR CANCELLATION: Sections 391.15(b)(2) and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT BUSINESS DAY of any revocation, suspension, cancellation, or disqualification of your driver’s license or driving privilege. In addition, Section 383.31 requires that any time you are convicted of violating a state or local traffic law (other than parking), you must report it within 30 days to your employing motor carrier. The notification must be in writing.
CDL DOMICILE REQUIREMENT: Section 383.23(a)(2) requires that your commercial driver’s license be issued by your legal state of domicile, where you have your true, fixed an permanent home and principal residence and to which you have the intention of returning whenever you are absent. If you establish a new domicile in another state, you must apply to transfer your CDL within 30 days.

The following license is the only one I possess:

Driver's License No. *

Exp. Date *

DRIVER CERTIFCATION: I certify that I have read and understood the above requirements.

I certify that I have read and understood the above requirements. *

Notes

Eagle Eye Truck Lines is an equal opportunity employer