Driver Application
& Compliance Forms

Complete all required sections. All information is handled in accordance with DOT regulations and FMCSA requirements. Ensure all documents are accurate and complete before submitting.

CDL Driver Job Application

Personal information, license details, and supporting document uploads.

Personal Information

First Name *

Middle Name

Last Name *

Date of Birth *

SSN (Last 4 digits)

Phone Number *

Email Address *

Alternate Phone

Street Address *

City *

State *

ZIP Code *

Years at Address

CDL License Information

CDL Number *

Issuing State *

CDL Class *

Expiration Date *

Medical Card Expiration

Years of CDL Experience *

Endorsements

Restrictions / Limitations

Position Details

Position Applying For *

Desired Start Date

Willing to be away from home

Are you a US Citizen or authorized to work?

Yes No

How did you hear about us?

Driving & Safety History

Accidents in past 3 years?

Yes No

Traffic violations in past 3 years?

Yes No

DUI/DWI conviction in past 5 years?

Yes No

License ever suspended or revoked?

Yes No

If Yes to any above, please explain

Document Uploads

ℹ️ Upload clear, legible copies. Accepted formats: PDF, JPG, PNG. Max 10MB per file.

CDL (Front & Back) *

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Click to upload or drag & drop

Medical Certificate (DOT Physical) *

🏥

Click to upload or drag & drop

Social Security Card or Proof of Work Authorization

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Click to upload or drag & drop

Hazmat / Additional Endorsements (if applicable)

⚠️

Click to upload or drag & drop

Additional Documents (voided check, insurance, etc.)

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Click to upload or drag & drop any additional documents

Form 1 of 4

Previous Employment Verification

FMCSA requires 10-year employment history for CDL drivers. List all employers, beginning with most recent. (49 CFR 391.21)

FMCSA Requirement: Federal Motor Carrier Safety Regulations require motor carriers to investigate the driving record of each driver applicant for the 3 preceding years. Drivers must provide employment history for the past 10 years. Previous employers must be contacted to verify safety performance history including accidents, violations, alcohol/drug test results, and refusals to test.

Employer #1 — Most Recent

Company Name *

DOT Number (if known)

Contact Name

Phone Number *

Fax Number

Address

Email Address

Position Held

Date of Employment (From) *

Date of Employment (To) *

Subject to FMCSA regulations?

Yes No

Subject to DOT drug/alcohol testing?

Yes No

Reason for Leaving *

Were you terminated or asked to resign?

Yes No

Equipment Operated (e.g. 53' dry van, flatbed, tanker)

Did you have any accidents while employed here?

Yes No

If yes, describe (date, nature, fault determination)

Gaps in Employment

ℹ️ All gaps in employment of 30 days or more must be explained per FMCSA regulations.

Explain any gaps in employment (include dates)

Release Authorization — Previous Employment

I hereby authorize each of the employers listed above to release to [Carrier Name] any and all information regarding my employment, including but not limited to: dates of employment, job performance, accidents, traffic convictions, alcohol/drug violations, and any other safety performance history as required by 49 CFR Part 391. I release all parties from liability in connection with the release of such information.

Applicant Full Name (Print) *

Date *

Signature *

Sign here

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Form 2 of 4

Motor Vehicle Record (MVR) Authorization

Required under 49 CFR 391.23 — Authorization to obtain driving record from state DMV.

Purpose: Federal regulations require motor carriers to obtain a copy of your Motor Vehicle Record (MVR) from every state in which you held a driver's license in the past 3 years. This authorization allows [Carrier Name] and its designated agents to obtain such records for purposes of evaluating your qualifications as a commercial driver.

Driver Information

Full Legal Name (Last, First, MI) *

Date of Birth *

Social Security Number *

Current Home Address *

Years at Current Address

Previous Address (if less than 3 years at current)

License History — All States (Past 3 Years)

ℹ️ List every state where you held a driver's license in the past 3 years, including current license.

State *

License Number *

Expiration Date

Authorization & Consent

I, the undersigned, hereby authorize [Carrier Name], its employees, agents, and designated representatives to obtain my Motor Vehicle Record (MVR) from the Department of Motor Vehicles (DMV) or equivalent licensing authority of any and all states listed above, and any other state in which I have held a driver's license in the past three (3) years.

I understand this record may include information regarding my driving history, including but not limited to: moving violations, accidents, DUI/DWI convictions, license suspensions or revocations, and other matters of record. I authorize the release of this information solely for the purpose of evaluating my qualification for employment as a commercial motor vehicle driver, in compliance with 49 CFR Part 391.

I certify that the information provided is true and accurate to the best of my knowledge.

Applicant Full Name (Print) *

Date *

Signature *

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Form 3 of 4

FMCSA Drug & Alcohol Clearinghouse Authorization

Required under 49 CFR Part 382 — Full Query consent for Drug & Alcohol Clearinghouse.

What is the Clearinghouse? The FMCSA Drug & Alcohol Clearinghouse is a secure online database that gives employers real-time information about CDL drivers' drug and alcohol program violations. As of January 6, 2020, all motor carriers must query the Clearinghouse for current and prospective CMV drivers. A full query requires the driver's electronic consent.

Driver Identification

Full Legal Name *

Date of Birth *

CDL Number *

CDL Issuing State *

Email Address *

Phone Number

Query Type & Consent

Type of Query Being Authorized *

Full Query — Provides complete violation history. Required for pre-employment. Driver must provide electronic consent.

Limited Query — Reveals only whether a record exists (no details). For annual/random checks on current employees. No driver consent required.

Full Query Authorization:
I, the undersigned CDL holder, hereby provide my consent to [Carrier Name] (USDOT #: ____________) to conduct a Full Query of the Federal Motor Carrier Safety Administration (FMCSA) Commercial Driver's License Drug and Alcohol Clearinghouse to obtain information about my drug and alcohol program violations as defined in 49 CFR Part 382.

I understand that:
• This query will reveal information about violations of FMCSA drug and alcohol testing requirements, including positive test results, refusals to test, and return-to-duty status.
• This information will be used solely to evaluate my eligibility and qualifications to operate a commercial motor vehicle for [Carrier Name].
• I have the right to review information obtained through this query.
• I may contact the Clearinghouse at clearinghouse.fmcsa.dot.gov to review my own record.
• This consent is valid for a period of 30 days from the date of signature below and applies only to the employer named above.

Acknowledgment * I have read and understand the above authorization and voluntarily consent to the Clearinghouse query described above.

Previous Violations Disclosure

ℹ️ Drivers are required to disclose any known violations prior to query. Failure to disclose may result in disqualification.

Do you have any violations currently in the Clearinghouse? *

Yes No Unknown / Not Sure

Have you completed a Return-to-Duty (RTD) process? *

Yes No N/A

Additional Comments (optional)

Signature & Certification

Applicant Full Name (Print) *

Date Signed *

Signature *

Sign here

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By signing above, I certify under penalty of perjury that all information provided in this application and all attached forms is true, accurate, and complete to the best of my knowledge. I understand that any material misrepresentation or omission may result in immediate disqualification or termination.

Form 4 of 4

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Application Submitted

Thank you for applying. Your application has been received and all documentation is under review. Our team will contact you within 2–3 business days.

REF #CDL-000000

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Driver Application& Compliance Forms

CDL Driver Job Application

Previous Employment Verification

Motor Vehicle Record (MVR) Authorization

FMCSA Drug & Alcohol Clearinghouse Authorization

Driver Application
& Compliance Forms