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Apply to Truck with Performance Corp.

Full Driver Application

In Compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disability.

Step 1 of 4

25%

Personal Details

NAME(Required)
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ADDRESS(Required)
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WHAT POSITION ARE YOU APPLYING FOR?(Required)

DO YOU HAVE THE LEGAL RIGHT TO WORK IN THE UNITED STATES?(Required)
HAVE YOU WORKED FOR PERFORMANCE CORP BEFORE?(Required)
ARE YOU NOW EMPLOYED?(Required)
IS THERE ANYTHING THAT MIGHT INHIBIT YOU FROM PERFORMING TASKS RELATED TO THE POSITION YOU HAVE APPLIED FOR?(Required)
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Have you ever been denied a license, permit, or privilege to operate a motor vehicle?(Required)
Has any license, permit or privilege ever been suspended or revoked?(Required)
Notice to Applicant: Before you continue in filling out the remainder of this application we must inform you that the information you have provided so far, and any and all information you are about to disclose, in accordance with 49 CFR part 391.21(b)(10) of the Federal Motor Carrier Safety Regulations (FMCSR's) may be used, and your previous employers "will be"contacted for the purpose of investigating your safety performance history as required by 391.23(d), and 391.23(e) of the FMCSR's. If it has not already been provided for you, please ask for a written copy of your "due process rights" regarding any and all information obtained during the processing of your history as specified in 391.23(i).

Employment History

All driver applicants to driver in interstate commerce must provide the following information on all employers during the preceding three (3) years. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional seven (7) years information on the employers for whom the applicant operated such a vehicle. List Employers in reverse order starting with the most recent. *Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designated to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

Employer 1

Address
Were you subject to the FMCSR's in this position while employed by this previous employer? 391.21(b)(10)(iv)(A)
Was this position designated as a safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing? 391.21(b)(10)(iv)(A)

Employer 2

Address
Were you subject to the FMCSR's in this position while employed by this previous employer? 391.21(b)(10)(iv)(A)
Was this position designated as a safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing? 391.21(b)(10)(iv)(A)

Employer 3

Address
Were you subject to the FMCSR's in this position while employed by this previous employer? 391.21(b)(10)(iv)(A)
Was this position designated as a safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing? 391.21(b)(10)(iv)(A)

Other Employers

ACCIDENT RECORD (Past three (3) years)

Fatalities
Injuries
Fatalities
Injuries

Traffic convictions and Forfeitures (past three (3) years (other than parking violations.)

Education

Driver Qualification/Licenses

State
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State
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State
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Have you ever been denied a license, permit, or privilege to operate a motor vehicle?(Required)
Has any license, permit, or privilege ever been suspended or revoked?(Required)

Driving Experience (If none, write NONE)

To Be Read and Signed By Applicant

Sec. 40.25(j) As the employer, you must also ask the employee whether he or she has tested positive or refused to test, on any pre-employment drug or alcohol test administered by an employer to which the employee applied for, but did not obtain, safety sensitive transportation work cover by DOT agency drug and alcohol testing rules during the past two years. If the employee admits that he or she had a positive test or a refusal to test, you must not use the employee to perform safety sensitive functions for you until and unless the employee documents successful completion of the return-to-duty process. (see Sec. 40.25 (b)(5) and (e). The prospective employee is required by Sec 40.25(j) to respond to the following questions.
1) Have you ever tested positive or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years?
2) If you answered yes, can you provide/obtain proof that you have successfully completed the DOT return-to-duty requirements?

To Be Read and Signed By Applicant

This agreement releases Performance Transportation Corp. from all liability relating to injuries that may occur during pre-employment testing/activities. By signing this agreement, I agree to hold Performance Transportation Corp. entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I also acknowledge the risks involved in pre-employment activities. These include but are not limited to personal injury. I swear that I am participating voluntarily, and that all risks have been made clear to me. Additionally, I do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity. By signing below I forfeit all right to bring a suit against Performance Transportation Corp. for any reason. In return, I will receive the ability to perform activities relating to pre-employment with the company. I will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I will ask for clarification when needed.
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Submit Application

This certifies that I completed this application, and that all entries, and information documented by me are true and complete to the best of my knowledge. By my signature heretofore, I acknowledge having been given by this carrier which has presented me with this application, a statement of my right to due process as outlined by all parts of 49 CFR Part 391.23 of the Federal Motor Carrier Safety Regulations effective October 29, 2004.Having made this acknowledgment, I therefore authorize you to make such previous employment and background investigations and inquires of my personal, employment, financial or medical history and other related matters as may be necessary to arrive at a possible employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I understand that false or misleading information given in my application or interviews may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the company.
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.
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  • About
    • Sustainability
    • Production Capabilities
    • Testimonials
    • Meet the Team
    • News
  • Products
    • Pallets
    • Firewood
    • Animal Bedding
    • Mulch
  • Join the Team
    • Seymour, WI Openings
    • Carney, MI Openings
    • Truck for Us
  • Contact Us