• 9615 Continental Industrial Drive  St. Louis,  Missouri  63123
  • 314-631-3001

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Application for Employment

Dino's Trucking, Inc.
9615 Continental Industrial Drive
St. Louis,  Missouri  63123
314-631-3001
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*If at current address less than 3 years, list below most recent addresses for the past 3 years.
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Commercial Drivers License

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CDL Type
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Air Brake Restriction? *
Endorsements (check all that apply)
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Current DOT Medical Card *

Driving/Hauling Experience

Education

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Additional Licenses

Drivers licenses held in the past 3 years must be shown.

Accident Review for Past 3 Years

Last Accident

Traffic Convictions & Forfeitures for Past 3 Years

Employment History

You must provide accurate dates of employment and phone numbers covering the last ten years (per DOT regulation). We cannot hire you without verifying employment. If you need to list additional employers, click "Add Another Employer" below.
EMPLOYER #1
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Driving/Hauling Experience With This Employer
You can add only 15 employers!

May we contact current employer?           Yes    No

Authorization

By clicking "Send" below, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, any falsified statements on this application shall be grounds for dismissal. Under the provisions of the Fair Credit Reporting Act, the Americans With Disabilities Act, the Drivers Privacy Protection Act and all other applicable federal, state, and local laws I authorize investigation of all statements contained herein as well as authorize the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise.

I hereby release and hold harmless any person, firm, or entity that discloses information in accordance with this authorization, as well as my prospective employer, and its agents, from any liability that may otherwise result from the request for, use of, or disclosure of, any or all of the foregoing information. The above-mentioned investigations may include, but are not limited to, information as to my character, general reputation, work history, or lifestyle, discerned through employment and education verifications; personal references; personal interviews; my personal credit history based on reports from any credit bureau; my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history records; or any other public record.

I understand that consumer reports which may contain public record information may be requested, at the discretion of my prospective employer, which may include names, dates of employment, reason for termination, work experience, traffic records, workers compensation claims, etc. I have the right, under the provisions of the Fair Credit Reporting Act and the Drivers Privacy Protection Act to request all such information from the reporting agency, upon proper identification, and to request the nature and substance of all information; and the receipt of any reports on me, which the reporting agency has, or will, furnish for the two preceding years. I am also entitled to a copy of my consumer rights under the Fair Credit Reporting Act. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.

I understand that under Regulation 391.23 I have the following rights:

  • The right to review information provided by previous employers
  • The right to have errors in the information corrected be the previous employer and for that employer to resend the corrected information to the prospective employer
  • The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

If I wish to review a previous employer-provided information I must submit a written request to the prospective employer when applying as late as 30 days after being employed or being notified of denial of employment. The prospective employer must provide this information to me within five business days of receiving the written request. If I have not arranged to pick up or receive the requested records within 30 days of the prospective employer making them available, the prospective motor carrier may consider me to have waived my request to review the records.

If I wish to request correction of erroneous information in records I must send the request for the correction to the previous employer that provided the records. After October 29, 2004, the previous employer must either correct and forward the information to the prospective motor carrier employer or notify me within 15 days of receiving my request to correct the data that it does not agree to correct the data. If I wish to rebut information in records I must send the rebuttal to the previous employer with instructions to include the rebuttal in my driver's Safety Performance History.


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This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

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Review your signature

Date: 2018-02-25 13:26:12

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If you are finished with your application and would like to turn it in please click "Send". Once you Send it you will not be able to make any additional changes.