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HAZMAT CDL DRIVER JOB APPLICATION

Applicant Information

Position Applied For

Please Selected Position You Are Applying For

Drivers License Info

State Issued
Class
Tanker Endorsement

Driving Experience

Type of Vehicles Driven

List Your Past 3 Employers (Most recent first)

Employer 1

Employer 2

Employer 3

Driving Record

License Suspended/Revoked?
Yes
No
Any Accidents in The Past 3 Years?
Yes
No
Any Moving Violations in The Past 3 Years?
Yes
No

DOT & HAZMAT Requirements

Pass a DOT Physical?
Yes
No
Willing to Undergo Drug/Alcohol Testing?
Yes
No
Prior HAZMAT Experience?
Yes
No

References

Reference 1

Reference 2

Certification & Acknowledgement

I certify that the information provided in this application is true and complete. I authorize verification of

employment, driving record, and background check as required by DOT regulations.

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