FILL IN ALL BLANKS AND PROVIDE ALL INFORMATION REQUESTED

Email address

Name

First Middle Last

Address

Street City State Zip Phone Alternate Phone

Are you at least 18 years of age?

yes no

Are you legally eligible to work in the U.S.?

yes no

Date Available

Days available to work

Sun Mon Tues Wed Thurs Fri Sat

Hours available

Morning Mid Day Evenings Overnights Any shift available

If your above address is less than 3 years, continue listing them below to cover the last 3 years

Street City State Zip From date To date

 

 

Street City State Zip From date To date

 

 

Street City State Zip From date To date

Driver’s license information

State Number Expiration Date State Number Expiration Date

Driving Experience

Type of vehicle Dates Miles driven Type of vehicle Dates Miles driven

All Accidents in the last 3 years (if none, write none)

Date Violation State

Commercial Vehicle?

yes no

Date Violation State

Commercial Vehicle?

yes no

Date Violation State

Commercial Vehicle?

yes no

Date Violation State

Commercial Vehicle?

yes no

Date Violation State

Commercial Vehicle?

yes no

 

 

Employment History – last 10 years (Minnesota Stat. 383.35) account for gaps between employers. (if owner/operator, list carriers leased to)

1

Employer Date from Date to Street City State Zip Telephone Supervisor

Were you subject to the Federal Motor Carrier Safety Regulations during this period?

yes no

Were you subject to 49 CFR part 40 controlled substance and alcohol testing during this period?

yes no

Reason for leaving

2

Employer Date from Date to Street City State Zip Telephone Supervisor

Were you subject to the Federal Motor Carrier Safety Regulations during this period?

yes no

Were you subject to 49 CFR part 40 controlled substance and alcohol testing during this period?

yes no

Reason for leaving

3

Employer Date from Date to Street City State Zip Telephone Supervisor

Were you subject to the Federal Motor Carrier Safety Regulations during this period?

yes no

Were you subject to 49 CFR part 40 controlled substance and alcohol testing during this period?

yes no

Reason for leaving

4

Employer Date from Date to Street City State Zip Telephone Supervisor

Were you subject to the Federal Motor Carrier Safety Regulations during this period?

yes no

Were you subject to 49 CFR part 40 controlled substance and alcohol testing during this period?

yes no

Reason for leaving

Answer the following questions by selecting 1-5, one being highly uncomfortable and 5 being extremely comfortable. Please answer all questions, even though some of the questions will not pertain to the job you applied for.

What is your comfort level with smart phones and technology?

1 2 3 4 5

How well do you multi-task? Driving in traffic, following GPS, talking with a client, etc.

1 2 3 4 5

What is your comfort level with bumper-to-bumper traffic?

1 2 3 4 5

How do you feel about driving in the dark and in bad weather?

1 2 3 4 5

How do you feel about transporting and interacting with children?

1 2 3 4 5

How do you feel about transporting and interacting with children with special needs?

1 2 3 4 5

How do you feel about the physical work of installing child car seats and securing children?

1 2 3 4 5

How do you feel about transporting and interacting with the elderly and adults with disabilities?

1 2 3 4 5

How do you feel about transporting and interacting with people that speak/communicate differently than you?

1 2 3 4 5

How do you feel about the physical work of pushing and moving wheelchairs and the necessary physical labor to secure wheelchairs?

1 2 3 4 5

How comfortable are you working within an environment that can change on a moment's notice?

1 2 3 4 5

What is your comfort level with problem-solving on your own?

1 2 3 4 5

Yes or No Questions

Are you comfortable being fingerprinted and having those fingerprints going through a national database?

yes no

Have you had any DUIs in the past three years?

yes no

Will you pass a drug test?

yes no

Would you describe yourself as a reliable, dependable employee?

yes no

Which company(s) are you interested/willing to work for? Check one or more as applicable.

Companies

R&S Transport Kids on the Go ZIPS

Submit

For driver applicants of commercial motor vehicles that require a Commercial Driver License (CDL) the applicant must disclose their controlled substance and alcohol status per the requirements of 49 CFR part 40.25(j).

As a prospective driver employee, you have the right to review information provided by previous employers. You have the right to have errors in the information corrected by the previous employer(s) and for that previous employer(s) to re-send 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.

Driver employees who have previous Department of Transportation regulated employment history in the preceding three years, and wish to review previous employer provided investigative information, must submit a written request to the prospective employer, which may be done at anytime, including when applying or as late as thirty (30) days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), then the five (5) business day deadlines will begin when the prospective employer receives the requested safety performance history information. If the driver has not arranged to pick up or receive the requested records within thirty (30) days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived their request to review the records.

In exchange for the consideration of my job application by Best Ride, hereinafter called “the Company”), I agree that:

 

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Best Ride, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President of the Company.

 

Both the undersigned and the Company may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

 

I certify that my answers are true and complete to the best of my knowledge. I authorize the representative of the company to make such investigations and inquiries of my personal, employment, educational, financial, criminal history and other related matters as may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application.

 

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in termination of my employment.

 

In the event I am employed, I authorize my employer to conduct a pre-employment as well as annual review of my driving record and criminal history during the entirety of my employment