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Leave no section without a response. If you do not know the answer, enter 'unknown'. If the question does not apply, enter 'N/A'.
Todays Date:
Last Name* :
First Name* :
MI:
Home Address* :
Home City* :
State* :
Zip* :
Are you at least 23 years of age? :
SSN:
Home Phone* :
Retype SSN:
Email Address* :
Magnum will contact you via this email address
Previous addresses for the past three years
Has your CDL ever been revoked?
Commercial Drivers License #
Physical expiration date
 
CDL Number:
CDL State:
Issue Date:
Expiration Date:
Driving experience (years)
Endorsements
 
Number of tickets in last 3 years:
Number of licenses held in last 3 years:
Number of accidents in last 3 years
Position desired *
Pay expected
Available to begin work?
How did you hear about Magnum? *
Have you ever applied for employment with Magnum?
Yes
No
If yes: month and year
 
In case of emergency notify:
Relationship
Phone
 
Other special training or skills (languages, machine operations, Safe Driving Awards, special courses)
 
School
Name & Location of School
Course of Study
# of Years Completed
Did you Graduate?
Degree or Diploma
High School
Trade/Technical
College
 
Employment  History
Please give complete employment history, including full-time and part-time work, as well as, any periods of unemployment. Any applicants with commercial driving experience you must list all employment for at least the past 10 years, those without need only list five (5) years.
Present or previous employer
Employer's Name* :
From (date)* :
To (date)* :
Address*
City*
State* :
Zip*
Phone*
Supervisor or contact
Number of States
Pay
Miles driven
Position held* :
Reason for leaving* :
Where you subject to the FMCSRs while employed?
Yes
No
Was the position designated as a safety sensitive function in any DOT regulated mode subject to controlled substances & alcohol testing?
Yes
No
Please click here to add more work experience -->
 
Dates
  
Class of Equipment
from
to
Total Number of Miles (approximately)
Straight Truck
Tractor/Semi-Trailer
Tractor/Two-Trailer
Other
 
List states operated in for the last five years:  
Have you ever been denied license or privilege to operate a motor vehicle?
Yes
No
If so, when?
Has your license, permit, or privileges ever been suspended or revoked?
Yes
No
If so, when?
Have you ever had a D.U.I. (or D.W.I.) or a felony conviction?
Yes
No
If so, when?
If yes to any of the last three questions, give details:
  
 
Accidents
Dates (past five years)
Nature (Backing, Rear-End, Upset, Etc.)
Number of Fatalities
Number of People Injured
 
Traffic Convictions
Dates (past five years)
Location
Charge
Penalty
 

Drivers License
(list each drivers license held in the past three years)

State
License Number
Type
Endorsements
Expires
 
It is agreed and understood that any misrepresentation given above shall be considered an act of dishonesty.
It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include Investigating Consumer Report, including information regarding my character, general reputation, personal characteristics and mode of living.
I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.
It is agreed and understood that if qualified, the driver may be on a probationary period during which time he or she may be disqualified without recourse.
This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best to my knowledge.
 
Release & Documentation of Pre-Employment Testing Information by Driver/Applicant
 
During the past (2) years, have you ever tested positive on a pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by the Department of Transportation (DOT) drug and alcohol testing rules?
Yes
No
 
During the past (2) years, have you refused to test on a pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by the Department of Transportation (DOT) drug and alcohol testing rules?
Yes
No
If you answered yes to either of the questions above, please provide documentation of your successful completion of the return-to-work process.
PLEASE READ THE FOLLOWING AGREEMENT

I understand that my eligibility is contingent upon satisfactory application and background reports. I hereby authorize Magnum to inquire of each of my former employers, references and all other persons having information concerning me. I also authorize the release of my traffic violation record to the company. This release shall remain in full force and e3ffect until formal withdrawal is filed by me. I acknowledge the company's right to use any recognized investigative technique for the detection of illegal drug or alcohol use or abuse. ; or for the detection of possession or theft of property o or involving the company's or its customers'' property or premises. As a condition of eligibility, I agree to cooperate fully in any such investigation, including participation in blood or urine test. I understand that this information and any other company documents are not contracts of employment, and that any individual who hired may voluntarily leave upon proper notice, and a may be terminated by the company at any time for any reason. I understand that oral or written statements to the contrary are hereby expressly disavowed and should not be relied upon by an prospective or existing employee or contractor. I also understand that I will be subject to a probationary period. This certifies that I agree with the above information and that all entries on this inquiry are true and complete to the best of my knowledge. I understand that this inquiry I have submitted is voluntary and is not an application, and is used for information purposes only.
 
IMPORTANT NOTICE REGARDING BACKGROUND REPORTS FROM THE PSP Online Service
 
In connection with your application for employment with Magnum Companies (“Prospective Employer”), it may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA). If the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing. If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize Magnum Companies (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee. I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I am challenging crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this consent form, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.
 
If you choose to DECLINE this agreement, please contact our Recruiting Department directly at 1-800-615-9398 to speak with a Recruiter.
 
Please indicate if you have read and ACCEPT the terms and conditions of the preceding officially-approved agreement:

I ACCEPT
* RESPONSE REQUIRED