AEC BROTHERS TRUCKING INC DRIVER APPLICATION

REQUIRED INFORMATION:

BEFORE STARTING THIS APPLICATION, YOU WILL NEED THE FOLLOWING INFORMATION AND DOCUMENTS:

DRIVER LICENSE
SOCIAL SECURITY CARD
MEDICAL DOT CARD
FMCSR PSP REPORT
ALL FORMER EMPLOYER INFORMATION FOR THE LAST 10 YEARS

ONCE YOU START THE APPLICATION, YOU MUST FINISH IT. THERE IS NO SAVING AND COMING BACK TO IT LATER.

WHCH POSITION ARE YOU APPLYING FOR?

PLEASE SELECT ONE OF THE FOLLOWING BELOW

DRIVER INFORMATION:

FIRST NAME

AS APPEARS IT ON DRIVER LICENSE

MIDDLE NAME

LAST NAME

ARE YOU ELIGIBLE TO WORK IN THE USA?

SOCIAL SECURITY NUMBER

DATE OF BIRTH

mm/dd/yyyy

PHONE NUMBER

Phone

CELL_PHONE#

Phone

PREFERRED METHOD OF CONTACT

CURRENT ADDRESS

CITY

STATE

ZIP CODE

SINCE

mm/dd/yyyy

HAVE YOU LIVED AT THIS RESIDENCE FOR 3 YEARS OR LONGER?

LICENSE INFORMATION:

DRIVER LICENSE #

CDL STATE

CDL COUNTRY

CDL EXPIRATION

mm/dd/yyyy

CDL CLASS

CDL ENDORSEMENT

DOT MEDICAL CARD EXPIRATION

mm/dd/yyyy

YEARS OF DRIVING EXPERIENCE

TYPE OF VEHICLES DRIVEN

Select all that applies.

GENERAL QUESTIONS:

WHAT LOCATION ARE YOU APPLING FOR?

HOW DID YOU HEAR ABOUT AEC BROTHERS TRUCKING?

DO YOU AGREE TO RECEIVE INFORMATION FROM AEC TRUCKING?

EDUCATION:

EDUCATION LEVEL

DO YOU READ AND SPEAK ENGLISH

CDL TRUCK DRIVING SCHOOL INFORMATION:

DID YOU GO TO A TRUCK DRIVING SCHOOL?

ACCIDENT REPORTING:

ACCIDENT REPORTING, FOR THE PAST 5 YEARS.

HAVE YOU HAD AN ACCIDENT OR TRAFFIC VIOLATION IN THE PAST 5 YEARS?

AEC WORK HISTORY

HAVE YOU WORKED FOR AEC BROTHERS TRUCKING?

WORK HISTORY:

YOU NEED 10 YEARS OF WORK HISTORY IN ORDER TO COMPLETE YOUR APPLICATION.

THIS IS NOT JUST DRIVING BUT ALL WORK HISTORY IN THE PAST 10 YEARS

ARE YOU CURRENTLY UNEMPLOYED

Please Select One.

FEDERAL MOTOR CARRIER QUESTIONS.

PLEASE READ CAREFULLY AND ANSWER THE QUESTIONS

UNDER FMCSR 391.15

UNDER FMCSR 391.15, ARE YOU CURRENTLY DISQAULIFIED FROM DRIVING A COMMERCIAL MOTOR VEHICLE? (49 CFR 391.15)

SELECT ONE.

UNDER FMCSR 391.21

HAS YOUR LICENSE, PERMIT OR PRIVILEGE TO DRIVE EVER BEEN SUSPENDED OR REVOKED FOR ANY REASON? (49 CFR 391.21)

SELECT ONE.

UNDER FMCSR 391.21

HAVE YOU EVER BEEN DENIED A LICENSE, PERMIT, OR PRIVILRGE TO OPERATE A MOTOR VEHICLE? (49CFR 391.21

SELECT ONE.

49 CFR 40.25(j)

WITHIN THE PAST TWO YEARS, HAVE YOU TESTED POSITIVE, OR REFUSED TO TEST, ON A PRE-EMPLOYMENT DRUG OR ALCOHL TEST BY AN EMPLOYE TO WHOM YOU APPLIES, BUT DID NOT OBTAIN, SAFETY-SENTITIVE TRANSPORTATION WORK COVERED BY DOT AGENCY DRUG AND ACOHOL TESTING RULES? 49 CFR 40.25(j)

SELECT ONE.

49 CFR 391.15

IN THE PAST THREE (3) YEARS, HAVE YOU EVER BEEN CONVICTED OF ANY OF THE FOLLOWING OFFENSES UNDER 49 CFR 391.15:

DRIVING A COMMERCIAL MOTOR VEHICLE WITH A BLOOD ALCOHOL CONCENTRATION (BAC) OF .04 PERCENT OR MORE
DRIVING UNDER THE INFLUENCE OF ALCOHOL, AS PRESCRIBED BY STATE LAW
REFUSAL TO UNDERGO DRUG ALCOHOL TESTING AS REQUIRED BY ANY JURISDICTION FOR THE ENFORCMENT OF FEDERAL MOTOR CARRIER SAFETY ACT REGULATIONS
DRIVING A COMMERCIAL MOTOR VEHICLEUNDER THE INFLUENCE OF ANY 21 C.F.R. 1308.11 SCHEDULE CONTROLLED SUBSTANCE, AN AMPHETAMINE, A NORCOTICDRUG, A FORMULATION OF AN AMPHETAMINE, OR A DERIVATIVE OF A NARCOTIC DRUG
TRANSPORTATION, POSSESSION, OR UNLAWFUL USE OF A 21 C.F.R. 1308.11 SCHEDULE 1 INDENTIFIEDCONTROLLED SUBSTANCE, AMPHETAMINES, NARCOTIC DRUGS, FORMULATIONS OF AN AMPHETAMINE, OR DERIVATIVES OF NARCOTIC DRUGS WHILE YOU WERE ON DUTY DRIVING FOR A MOTOR CARRIER
LEAVING THE SCENE OF AN ACCIDENT WHILE OPERATINGA COMMERCIAL MOTOR VEHICLE
OR ANY OTHER FELONY INVOLVING THE USE OF COMMERCIAL MOTOR VEHICLE.

SELECT ONE.

FEDERAL FCRA SUMMARY OF RIGHTS ACKNOWLEDGMENT

I, ACKNOWLEDGE THT I HAVE READ AND UNDERSTAND THE FCRA SUMMARY OF RIGHT ALSO HAVE BEEN GIVEN THE OPPORTUNITY TO COPY/PRINT IT AND AGREE TO THE ELECTRONIC SIGNATURE TO DEMOSTRATE MY CONSENT. ELECTRONIC SIGNATURE IS A LEGALLY BINDING AS AN INK SIGNATURE.

ACKNOWLEDGEMENT.

PSP DISCLOSURE AND AUTHORIZATION

I, ACKNOWLEDGE THT I HAVE READ AND UNDERSTAND THE PSP DISCLOSURE AND AUTHORIZATION AND ALSO HAVE BEEN GIVEN THE OPPORTUNITY TO COPY/PRINT IT AND AGREE TO THE ELECTRONIC SIGNATURE TO DEMOSTRATE MY CONSENT. ELECTRONIC SIGNATURE IS A LEGALLY BINDING AS AN INK SIGNATURE.

ACKNOWLEDGEMENT.

FCRA DISCLOSURE

BY ANSWERING, I, ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE AND ALSO HAVE BEEN GIVEN THE OPPORTUNITY TO COPY/PRINT IT AND AGREE TO THE ELECTRONIC SIGNATURE TO DEMOSTRATE MY CONSENT. ELECTRONIC SIGNATURE IS A LEGALLY BINDING AS AN INK SIGNATURE.

ACKNOWLEDGEMENT.

FCRA AUTHORIZATION

ACKNOWLEDGEMENT.

EMPLOYEMNT VERIFICATION ACKNOWLEDGMENT AND RELAESE (DOT DRUG AND ALCOHOL)

ACKNOWLEDGEMENT.

SUMMARY OF RIGHTS UNDER 15 U.S.C. SECTION 1681m(a)

BY ANSWERING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE SUMMARY OF RIGHTS UNDER SECTION 15 U.S.C. SECTION 1681m AND BEEN GIVEN THE OPPORTUNITY TO COPY/PRINT THE 1681m SUMMARY OF TIGHTS AND AGREE TO USE ELECTRONIC SIGNATURE TO DEMONSTRATE MY CONSENT. AN ELECTRONIC SIGNATURE IS A LEGALLY BINDING AS AN INK SIGNATURE.

ACKNOWLEDGEMENT.

INVESTIGATIVE CONSUMER REPORT DISCLOSURE

BY ANSWERING, I REPRESENT THAT I UNDERSTAND AND AGREE TO THE ABOVE INVESTIGATIVE CONSUMER REPORT DISCLOSURE.

AGREEMENT

DOCUMENTS REQUIRED FOR PROCESSING.

REQUIRED DOCUMENTS:
PHOTO OF YOUR DRIVER LICENSE FRONT
PHOTO OF YOUR DRIVER LICENSE BACK
PHOTO OF YOUR SOCIAL SECURITY CARD FRONT
PHOTO OF YOUR SOCIAL SECURITY CARD BACK
PHOTO OF YOUR MEDICAL DOT CARD
OPTIONAL DOCUMENT:
COPY OF YOUR PSP / CSA REPORT.

DOCUMENT UPLOADED HERE

Drop your files here

CONFIRMATION OF INFORMATION

BY TYPING YOUR NAME, YOU AGREED TO THE INFORMATION THAT YOU HAVE PROVIDED IS CORRECT AN ACCURATE TO THE BEST OF YOUR KNOWLEDGE.

DRVR_SIGN

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