AEC BROTHERS TRUCKING INC DRIVER APPLICATION

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

Select

TRUCK INFORMATION.

TRUCK YEAR.*

TRUCK MAKE.*

TRUCK MODEL.*

TRUCK VIN#.*

TRUCK # OF AXLES.*

TRUCK TYPE.*

Select

TRUCK WHEEL BASE (Inches).*

TRUCK WEIGHT.*

TRUCK MILES.*

TRUCK KIT.*

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DO YOU OWN A TRAILER?*

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TRAILER INFORMATION.

TRAILER TYPE.*

Select

TRAILER YEAR.*

TRAILER MAKE.*

TRAILER MODEL.*

TRAILER VIN#.*

TRAILER WEIGHT.*

TRAILER LENGHT.*

TRAILER # AXLES.*

DRIVER INFORMATION:

FIRST NAME*

AS APPEARS IT ON DRIVER LICENSE

MIDDLE NAME

LAST NAME*

ARE YOU ELIGIBLE TO WORK IN THE USA?*

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SOCIAL SECURITY NUMBER*

DATE OF BIRTH*

PHONE NUMBER*

Phone

CELL_PHONE#*

Phone

EMAIL*

PREFERRED METHOD OF CONTACT*

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CURRENT ADDRESS*

CITY*

STATE*

Select

ZIP CODE*

SINCE*

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

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PREVIOUS RESIDENCE 1

PREVIOUS ADDRESS*

CITY*

STATE*

Select

ZIP*

STARTING DATE*

ENDING DATE*

DO ALL DATES ENTERED ARE 3 YEARS OR LONGER?

Please enter accurately.

Select

PREVIOUS RESIDENCE 2

PREVIOUS ADDRESS*

CITY*

STATE*

Select

ZIP*

START DATE*

END DATE*

DO ALL DATES ENTERED ARE 3 YEARS OR LONGER?

Select

PREVIOUS RESIDENCE 3

Our recruitment department will contact you for more information.

LICENSE INFORMATION:

DRIVER LICENSE #*

CDL STATE*

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CDL COUNTRY*

Select

CDL EXPIRATION*

CDL CLASS*

Select

CDL ENDORSEMENT*

Select

DOT MEDICAL CARD EXPIRATION*

YEARS OF DRIVING EXPERIENCE*

Select

TYPE OF VEHICLES DRIVEN*

Select all that applies.

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GENERAL QUESTIONS:

WHAT LOCATION ARE YOU APPLING FOR?*

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HOW DID YOU HEAR ABOUT AEC BROTHERS TRUCKING?*

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DO YOU AGREE TO RECEIVE INFORMATION FROM AEC TRUCKING?*

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RECEIVE INFORMATION VIA (CHOOSE OPTION)*

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EDUCATION:

EDUCATION LEVEL*

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SCHOOL NAME*

SCHOOL START DATE*

SCHOOL END DATE*

SCHOOL CITY*

SCHOOL STATE*

Select

WHAT WERE YOUR STUDIES*

SCHOOL GRADUATION DATE*

DO YOU READ AND SPEAK ENGLISH*

Select

CDL TRUCK DRIVING SCHOOL INFORMATION:

DID YOU GO TO A TRUCK DRIVING SCHOOL?*

Select

NAME OF TRUCK DRIVING SCHOOL*

WHEN DID YOU GRADUATE*

ACCIDENT REPORTING:

ACCIDENT REPORTING, FOR THE PAST 5 YEARS.

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

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ACCIDENT REPORTING 1

DATE*

WHAT TYPE?*

Select

ENTER STATE WHERE ACCIDENT OR TRAFFIC VIOLATION HAPPENED.*

Select

WAS THIS IN A COMMERCIAL MOTOR VEHICLE?*

Select

DID YOU PAY A FINE?*

Select

AFTER THE ACCIDENT OR TRAFFIC VIOLATION, YOU LICENSE WAS...*

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HAVE YOU HAD ANY OTHER ACCIDENT OR TRAFFIC VIOLATION IN THE PAST 5 YEARS?*

Please select accurately.

Select

ACCIDENT REPORTING 2

DATE*

WHAT TYPE?*

Select

ENTER STATE WHERE ACCIDENT OR TRAFFIC VIOLATION HAPPENED.*

Select

WAS THIS IN A COMMERCIAL MOTOR VEHICLE?*

Select

DID YOU PAY A FINE?*

Select

AFTER THE ACCIDENT OR TRAFFIC VIOLATION, YOU LICENSE WAS...*

Select

HAVE YOU HAD ANY OTHER ACCIDENT OR TRAFFIC VIOLATION IN THE PAST 5 YEARS?*

Select

ACCIDENT REPORTING 3

DATE.*

WHAT TYPE?*

Select

ENTER STATE WHERE ACCIDENT OR TRAFFIC VIOLATION HAPPENED.*

Select

WAS THIS IN A COMMERCIAL MOTOR VEHICLE?*

Select

DID YOU PAY A FINE?*

Select

AFTER THE ACCIDENT OR TRAFFIC VIOLATION, YOU LICENSE WAS...*

Select

HAVE YOU HAD ANY OTHER ACCIDENT OR TRAFFIC VIOLATION IN THE PAST 5 YEARS?*

Select

ACCIDENT REPORTING 4

NOTE: Our recruitment department will contact you to obtain more information about your accident and traffic violation history.

AEC WORK HISTORY

HAVE YOU WORKED FOR AEC BROTHERS TRUCKING?*

Select

START DATE.*

TERMINATION DATE.*

REASON FOR TERMINATION.*

Please explain as best as you can.

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.

Select

UNEMPLOYMENT DATE START

REASON FOR UNEMPLOYMENT?

CURRENT EMPLOYMENT.

COMPANY NAME*

START DATE*

ADDRESS*

CITY*

STATE*

Select

ZIP*

CONTACT NAME*

PHONE #*

CURRENT POSITION*

DO YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW ARE YOU PAID?*

Select

REASON FOR LEAVING?*

Select

MAY WE CONTACT THE EMPLOYER?*

Select

HAVE YOU WORKED FOR YOUR CURRENT EMPLOYER FOR 10 YEARS OR MORE?*

Select

PREVIOUS EMPLOYMENT 1

Please enter previous employment.

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT.*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE YOU PAID?*

Select

REASON FOR LEAVING?*

Select

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

PREVIOUS EMPLOYMENT 2

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT.*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE PAID?*

Select

REASON FOR LEAVING?*

Select

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

PREVIOUS EMPLOYMENT 3

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT.*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE PAID?*

Select

REASON FOR LEAVING?*

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

PREVIOUS EMPLOYMENT 4

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT.*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE YOU PAID?*

Select

REASON FOR LEAVING?*

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

PREVIOUS EMPLOYMENT 5

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT?*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE YO PAID?*

Select

REASON FOR LEAVING?*

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

PREVIOUS EMPLOYMENT 6

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT?*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE YOU PAID?*

Select

REASON FOR LEAVING?*

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select or enter value

PREVIOUS EMPLOYMENT 7

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT?*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE YOU PAID?*

Select

REASON FOR LEAVING?*

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

PREVIOUS EMPLOYMENT 8

WERE YOU UNEMPLOYED BETWEEN JOBS*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT.*

COMPANY NAME*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WERE YOU PAID?*

Select

REASON FOR LEAVING?*

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

PREVIOUS EMPLOYMENT 9

WERE YOU UNEMPLOYED BETWEEN JOBS?*

Please Select One.

Select

START DATE.*

END DATE.*

REASON FOR UNEMPLOYMENT.*

COMPANY NAME.*

START DATE.*

END DATE.*

COMPANY ADDRESS.*

CITY.*

STATE.*

Select

ZIP.*

CONTACT NAME.*

PHONE #.*

POSITION HELD.*

DID YOU OPERATE A COMMERCIAL MOTOR VEHICLE?*

Select

HOW WER YOU PAID?

Select

REASON FOR LEAVING.*

DO ALL DATES ENTERED COMPLETE 10 YEARS OF WORK HISTORY?*

Please select accurately.

Select

10 YEARS OF WORK HISTORY INCOMPLETE.

Our recruiters will contact you about providing more information about your work history.

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.*

Select

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.*

Select

UNDER FMCSR 391.21

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

SELECT ONE.*

Select

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.*

Select

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.*

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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.*

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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.*

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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.*

Select

FCRA AUTHORIZATION

ACKNOWLEDGEMENT.*

Select

EMPLOYEMNT VERIFICATION ACKNOWLEDGMENT AND RELAESE (DOT DRUG AND ALCOHOL)

ACKNOWLEDGEMENT.*

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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.*

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INVESTIGATIVE CONSUMER REPORT DISCLOSURE

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

AGREEMENT*

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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

Drag and drop files here or

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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