Employment History Instructions: Please list all employment, companies leased to (past 3 years), commercial driving experience (past 10 years), and any periods of unemployment. Start with your most recent employer.

Applicant Certification:I hereby certify that all information provided in this application is true, correct, and complete to the best of my knowledge. I understand that any false statements, misrepresentations, or omissions of facts may prevent safety clearance from being issued, or may result in the immediate revocation of safety clearance and termination of employment if discovered at a later date.I authorize the company to conduct a thorough investigation of my background, including but not limited to my driving history, past employment, and drug/alcohol testing records as required for commercial vehicle operations.