Driver Application – RP Expediting LLC

Personal Information

First Name *

Middle Name

Last Name *

Date of Birth *

Address *

City *

State *

Zip *

Phone Number *

Phone Type *

Apple

Android

Other

Email Address *

Preferred Method of Contact *

Phone Number

Best time to contact? *

Anytime

Morning

Afternoon

Evening

What position are you applying for? *

Are you legally eligible for employment in the United States? *

Yes

Permanent Resident Card *

Yes

Irrelevant

Are you currently employed? *

Yes

Do you read, write and speak English? *

Yes

Have you ever worked for this company before? *

Yes

How did you hear about RP EXPEDITING?

Driving Experience

For each class of equipment, enter type of equipment (van, reefer, tank etc.), start and end dates, and approximate number of total miles. If no experience in a class enter none.

Straight Truck 20' to 26' *

Small Straight 12' to 18' *

Tractor and Semi-Trailer *

Sprinter and Cargo Van *

Other *

Drives License Number *

Drivers License State *

Drivers License Expiration *

How many states ran? *

Has your license been suspended/revoked? *

Yes

If yes, what year?

Have you ever received a DUI / DWI? *

Yes

If yes, what year?

Have you ever been convicted of a felony? *

Yes

If yes, what year?

Do you have an active Authority? *

Yes

If yes, what is your MC#

DOT# *

Equipment Type *

Year *

Make *

Model *

GVWR ( max weight) *

Box Length *

Box Width *

Box Height *

Does the cargo area have windows? *

Yes

Does the truck have at least 4 straps? *

Yes

Is the license plate temporary? *

Yes

Is the license plate for commercial use? *

Yes

Statement of Understanding *

Yes

I certify that I personally completed this application and that all of the information is true and correct. I authorize the above carriers to obtain any and all information (including, but not limited to, work history, alcohol/controlled substance testing, training records, and criminal history) from previous and current employer(s), Medical Review Officer or their agent, DAC services, or other consumer reports, in accordance with State and Federal laws. I authorize my previous and current employer( s) to release any information requested by the above carriers and hold them harmless of all liability from release of said information. I have read and understand the above statements and acknowledge by affixing my digital signature below. I have read and understand the above.

Full Name *

Date *

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Personal Information

Driving Experience