WT Transportation Application

Applicant Name *

Date of Birth *

Cell Phone Number *

Email *

Driver License Number *

Social Security Number *

List Areas of Residency for the Past 3 Years. Please include Address, City, State, ZIP, and Duration Lived There *

Can you provide proof of age? *

Yes

No

Do you have the legal right to work in the United States *

Yes

No

Have you worked for WT Transportation before? *

Yes

No

Can you perform the essential functions of a flatbed OTR driver? *

Yes

No

Who referred you or where did you see WT Transportation to inquire about employment?

What do you expect to net weekly after taxes? *

Have you had any accidents in the past 3 years while on the job? *

Yes

No

Please list companies that you have operated CDL-required equipment for in the past 7 years including company name, time frame worked for and reason for leaving. Please list the most recent employment at the top. *

I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have a right to: Review information provided by previous employers; have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. *

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Please list the equipment that you have operated, and the years and approximate miles of experience you have with each. *

Please list the states you have experience operating in. *

Highest education level *

Signing this block verifies that you have a current medical certificate through a NRCME-registered medical examiner. *

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Please list any traffic or DOT violations in past 3 years. *

Please sign this block to allow WT to check your driving record. Note: Please copy and paste this link in your browser for a summary of your rights under the FCRA https://www.shrm.org/resourcesandtools/tools-and-samples/hr-forms/pages/summaryofrightsunderthefcra.aspx *

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Sign this block to verify that all information given is true and accurate. *

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