PROTOSTAR LOGISTICS INC.
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Driver Application Form
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Driving Licence #
*
Driver License issuing State
*
License Type
*
CDL Class A
CDL Class B
Other
Date of Birth (MM/DD/YYYY)
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Citizenship
*
SIN/SSN#
*
Has your licence ever been suspended, denied or revoked:
*
-
NO
YES
Do you have any DOT defined accidents in the past three 3 years in which the driver was convicted for a moving violation ?
*
-
NO
YES
Do you have more than 2 moving violations in the past 3 years in any type of motor vehicle.
*
-
NO
YES
Do you have more than 24 months of verifiable OTR Class A experience
*
-
NO
YES
Have you had any felonies, DUI or DWI in the last 3 years
*
-
NO
YES
Home address of applicant
*
Line 1
Line 2
City
State
Zip Code
Country
Miles Driven CDL-Class 1/A (approx)
*
CDL - Class 1/A Licence since (Give Date)
*
Interested in Team Driving ?
*
Team Drivers earns 20% more than Solo drivers
Do you have a team mate ?
*
W
ork history
(if more space is needed please attach)
1. Company Name / State & City
*
Start-date Month/Year : End-date Month/Year
*
Job Type
*
Local - CDL
Regional - CDL
Coast to Coast CDL
Other (non CDL)
2. Company Name / State & City
*
Start-date Month/Year : End-date Month/Year
*
Job Type
*
Local - CDL
Regiona - CDLl
Coast to Coast - CDL
Other
3. Company Name / State & City
*
Start-date Month/Year : End-date Month Year
*
Job Type
*
Local - CDL
Regional - CDL
Coast to Coast - CDL
Other
Additional Info :
*
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