Non-Driver’s Application
Non-Driver's Application for Employment
Application for:
Doug Bradley Trucking, Inc.
680 E. Water Well Rd.
Salina, KS 67401
In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
TO BE READ AND SIGNED BY APPLICANT
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. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment 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 application.

In the event of employment, I understand that false or misleading information given in my application 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 understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand I have the right to:

  • Review information provided by previous employers;
  • Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
  • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
  • 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.
Typing your name in this field constitutes your signature
Today's Date
 
APPLICANT TO COMPLETE
(answer all questions)
List your addresses of residency for the past 3 years
Current Address
yr./mo.
Previous Addresses
yr./mo.
yr./mo.
yr./mo.
(Answer only if a job requirement)
(if applicable)
Conviction of a crime is not an automatic bar to employment - all circumstances will be considered.

Employment History

All applicants must provide the following information on all employers during the preceding 10 years. List complete mailing address, street number, city, state, and zip code.

Example: (999)999-9999
Mo. / Yr.
Mo. / Yr.
Example: (999)999-9999
Mo. / Yr.
Mo. / Yr.
Example: (999)999-9999
Mo. / Yr.
Mo. / Yr.
Example: (999)999-9999
Mo. / Yr.
Mo. / Yr.
Example: (999)999-9999
Mo. / Yr.
Mo. / Yr.
Example: (999)999-9999
Mo. / Yr.
Mo. / Yr.

DRIVERS LICENSE

List all driver licenses or permits held in the past 3 years

Mo. / Yr.
Mo. / Yr.
Mo. / Yr.

Experience and Qualifications - Other

Education

Last School Attended

TO BE READ AND SIGNED BY APPLICANT

I understand that typing my name in the signature field constitutes my electronic signature. 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.