Driver’s Application for Employment

Driver's Application for Employment

Electronic Version of Application for web submission.

Driver's Application for Employment*
- TO BE READ AND SIGNED BY APPLICANT I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. 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 the 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.
  
  Premier Coach
  946 Route 7 South
  Milton, VT 05468
  1-800-532-1811
Applicant Signature*

By typing my name in the box above I represent it as my signature and I authorize Premier Coach Company and Vermont Translines to fully investigate my background.
Date*
MM slash DD slash YYYY
We are an equal opportunity employer
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, veteran status, non-job related disability, or any other protected group status.
To attach a resume and cover letter please drag file here or click "Select Files" to browse. To complete our online application, please fill out the information below and skip this upload option.
Drop files here or

Max. file size: 50 MB, Max. files: 6.
Position Applied for*
Are you interested in full or part time?
Which terminal location is your preference? You may choose more than one.
- Milton, VT
- Rutland, VT
- Warner, NH
- Potsdam, NY
Rate of pay expected
Name*
First Last
Email*
Enter Email Confirm Email
Phone*
Date of birth (Required for Commercial Drivers)
Social Security Number
List your addresses for the past 3 years.*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
How long here?
Previous Address
Street Address City State / Province / Region ZIP / Postal Code
How long did you live here?
Do you have the legal right to work in the United States?
- Yes
- No
If you have worked for this company before, please list when and where.
Are you employed now?
- Yes
- No
If not employed now, how long since leaving your last employment?
How did you hear of our company? If referred by someone, please let us know.
Have you ever been bonded?
Name of bonding company
Have you ever been convicted of a felony?
If yes, please explain felony conviction. Conviction of a crime is not an automatic bar to employment. All circumstances will be considered. Use as much space as needed, box will expand to fit your entire submission.
Is there any reason you might be unable to perform the functions of the job for which you are applying?
Employment History
All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceeding three years. List complete mailing address for each employer. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years of information on those employers for whom the applicant operated a motor vehicle. Note: List employers starting with most recent and working backward. Use the free-form text box at the end of the application for additional employers if needed to cover a total of 10 years of employment history.
Most recent employer
Employer Name Address City State / Province / Region ZIP / Postal Code
Position
Rate of pay
Employer phone
Employer Email
Name of supervisor
First Last
Were you subjected to the FMCSRs while employed?
- Yes
- No
FMCSRs Information: The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) Weighs or has a GVWR of 1,001 pounds or more, (2) Is designed or used to transport 9 or more passengers, OR (3) Is of any size and is used to transport hazardous materials in a quantity requiring placarding.
Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
- Yes
- No
Employed From*
MM slash DD slash YYYY
to*
MM slash DD slash YYYY
Reason for Leaving*
Next Employer
Second most recent employer
Employer Name Address City State / Province / Region ZIP / Postal Code
Position
Rate of pay
Employer phone
Employer Email
Name of supervisor
First Last
Were you subjected to the FMCSRs while employed?
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
- Yes
- No
Employed From*
MM slash DD slash YYYY
to*
MM slash DD slash YYYY
Reason for Leaving*
Next Employer
Third most recent employer
Employer Name Address City State / Province / Region ZIP / Postal Code
Position
Rate of pay
Employer phone
Employer Email
Name of supervisor
First Last
Were you subjected to the FMCSRs while employed?
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
- Yes
- No
Employed From*
MM slash DD slash YYYY
to*
MM slash DD slash YYYY
Reason for Leaving*
Next Employer
Fourth most recent employer
Employer Name Address City State / Province / Region ZIP / Postal Code
Position
Rate of pay
Employer phone
Employer Email
Name of supervisor
First Last
Were you subjected to the FMCSRs while employed?
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
- Yes
- No
Employed From*
MM slash DD slash YYYY
to*
MM slash DD slash YYYY
Reason for Leaving*
Next Employer
Fifth most recent employer
Employer Name Address City State / Province / Region ZIP / Postal Code
Position
Rate of pay
Employer phone
Employer Email
Name of supervisor
First Last
Were you subjected to the FMCSRs while employed?
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
- Yes
- No
Employed From*
MM slash DD slash YYYY
to*
MM slash DD slash YYYY
Reason for Leaving*
Next Employer
Sixth most recent employer
Employer Name Address City State / Province / Region ZIP / Postal Code
Position
Rate of pay
Employer phone
Employer Email
Name of supervisor
First Last
Were you subjected to the FMCSRs while employed?
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?
- Yes
- No
Employed From*
MM slash DD slash YYYY
to*
MM slash DD slash YYYY
Reason for Leaving*
About your driving record
Accident record for past 3 years
Date of Accident Nature of Accident (head-on, rear-end, upset, etc... Fatalities? Injuries? Hazardous Spill?
Traffic Convictons and forfeitures for the past 3 years, other than parking violations. (If none, write NONE.)
Location Date Charge Penalty
List all driver licenses or permits held in the past 3 years
State License # Type Expiration Date
Have you ever been denied a license, permit of privilege to operate a motor vehicle?
- No
- Yes
If yes, provide details
Has any license, permit or privilege ever been suspended or revoked?
- No
- Yes
If yes, provide details
Driver licenses or permits held in the past 3 years
Straight Truck
Experience? Type of Equipment Dates: List From & To Approximate total number of miles driven
Tractor and Semi-Trailer
Experience? Type of Equipment Dates: List From & To Approximate total number of miles driven
Tractor -Two Trailers
Experience? Type of Equipment Dates: List From & To Approximate total number of miles driven
Tractor -Three Trailers
Experience? Type of Equipment Dates: List From & To Approximate total number of miles driven
Motor Coach - School bus (More than 8 passengers)
Experience? Dates: List From & To Approximate total number of miles driven
Motor Coach - School bus (More than 16 passengers)
Experience? Dates: List From & To Approximate total number of miles driven
List states operated in for the last 5 years
List special courses or training that will help you as a driver
List safe-driving awards you hold and from whom
List any trucking, transportation or other experience that may help in your work for this company
List courses and training other than those shown elsewhere in this application
List special equipment or technical materials you can work with other than any listed elsewhere in this application
Education
Grade School - Highest grade completed
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
HIgh School - Highest grade completed
- 9
- 10
- 11
- 12
College - Number years attended, if any
- 1
- 2
- 3
- 4
College Degree Earned?
- Yes
- No
If yes, what degree was earned in college?
To be read and signed by the applicant.

By typing my name in the box above which represents my signature and I certify that this application was completed by me and that all entries are true and complete to the best of my knowledge.
Commercial Vehicle Driver Applicant Controlled Substance and Alcohol Questionaire Pursuant to 49 CFR part 40.25(j)
Name
Prefix First Last Suffix
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Birthdate
MM slash DD slash YYYY
Social Security Number
Home Phone
Cell Phone
Email
Date
MM slash DD slash YYYY
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?
- Yes
- No
If yes, have you successullly completed the return-to-duty process?
- Yes
- No
If yes, documentation MUST BE PROVIDED before any safety-sensitive transportation function is performed.
To be read and signed by the applicant.

By typing my name in the box above which represents my signature and I certify that this Controlled Substance and Alcohol Questionaire was completed by me and that all entries are true and complete to the best of my knowledge.
Certification*
- 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.
Date*
MM slash DD slash YYYY
Applicant's Electronic Signature*
Name
This field is for validation purposes and should be left unchanged.

Mon	8:00 am — 5:00 pm
Tue	8:00 am — 5:00 pm
Wed	8:00 am — 5:00 pm
Thu	8:00 am — 5:00 pm
Fri	8:00 am — 5:00 pm
Sat	Closed
Sun	Closed

844-VTTRANS

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Driver’s Application for Employment

Driver's Application for Employment

We are an equal opportunity employer

Employment History

Next Employer

Next Employer

Next Employer

Next Employer

Next Employer

About your driving record

Driver licenses or permits held in the past 3 years

Education

Commercial Vehicle Driver Applicant Controlled Substance and Alcohol Questionaire Pursuant to 49 CFR part 40.25(j)

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Mailing Address

Phone

Email

Customer Service

Operators on Duty

844-VTTRANS

Date of Accident	Nature of Accident (head-on, rear-end, upset, etc...	Fatalities?	Injuries?	Hazardous Spill?

Location	Date	Charge	Penalty

State	License #	Type	Expiration Date

Experience?	Type of Equipment	Dates: List From & To	Approximate total number of miles driven