APPLY – Wadt Transportation

Driver Application

REPRESENTATIVE INFORMATION

Who is your Admin Representative?

Contact Information

First Name (required)

Last Name (required)

Address (required)

Alternate Address

City (required)

State (required)

Country (required)

Zip Code (required)

Primary Phone # (required)

Secondary Phone #

Email (required)

License Class (required)

PERSONAL INFORMATION

Date of Birth (required)

SSN (required)

Do you live in the States? (required)

Yes

Years at current residence? (required)

If '5+ Years' was NOT selected for the previous question, please list your address prior to your current address:

Can we call or text you regarding future opportunities?: (required)

Yes

Highest Level of Education (required)

MILITARY SERVICE

Were you ever in the military? If no to the above question, please skip to the next section. (required)

Yes

If yes, what branch?

Start Date (MM/YYYY)

End Date (MM/YYYY)

Honorable Discharge?

Yes

OWNER / OPERATOR INFORMATION

Are you an owner operator? If no, please skip to the next section (required)

Yes

Number of trucks owned

Truck Year

Truck Make

Truck Model

Do you own the truck outright?

Yes

Empty Gross Weight

Wheel Base

5th Wheel Height

Stack Height

DRIVER TRAINING SCHOOL

Have you ever attended a driving school? If no, please skip to the next section: Employment Information. (required)

Yes

School Name

School City

School State

Start Date (MM/YYYY)

Graduation Date (MM/YYYY)

EMPLOYMENT INFORMATION - Employer 1

Date Started

Dates Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving?

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 2

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving?

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 3

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length:

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 4

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length:

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 5

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length:

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 6

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 7

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 8

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type:

# of Days Out on the Road

# of States Driven:

Trailer Length:

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 9

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type Hauled

# of Days Out on the Road

# of States Driven

Trailer Length

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

EMPLOYMENT INFORMATION - Employer 10

Date Started

Date Ended

Company Name

Address

City

State

Zip Code

Phone

Fax

Operate a CMV?

Yes

Vehicle/Truck Driven

Trailer Type

# of Days Out on the Road

# of States Driven:

Trailer Length:

How many miles per week do you run with this company?

How much pay cent per mile "cpm" or hourly pay?

Reason for leaving:

Please Explain Why You Left The Company:

Additional Comments?

May we contact this employer?

Yes

Do you have any additional employers (any type) in the last 3 years OR any additional driving employers (Class-A or B CDL Jobs) within the last 3-10 years?

Yes

ADDITIONAL EMPLOYMENT

Add Any Additional Employment Details In The Box Below

Name of Company, City & State of Company, Date Started with Company, Dated Ended with Company, Reason for Leaving

REFERENCES

Add References In The Box Below

First and Last Name, Relationship to you, Phone Number

Add References In The Box Below

First and Last Name, Relationship to you, Phone Number

TRAFFIC CONVICTIONS

Do you have ANY traffic convictions within the last 5 years? (required)

Yes

Traffic Conviction 1 (If Applicable)

Date of Conviction (MM/YYYY)

Type of Vehicle Operating

Personally Operated Vehicle (POV)

Commercial Motor Vehicle (CMV)

Conviction Type

Additional Explanation:

Supporting Documents

Browse...

Maximum size 10MB

Traffic Conviction 2 (If Applicable)

Date of Conviction (MM/YYYY)

Type of Vehicle Operating

Personally Operated Vehicle (POV)

Commercial Motor Vehicle (CMV)

Conviction Type

Additional Information:

Supporting Documents

Browse...

Maximum size 10MB

Traffic Conviction 3 (If Applicable)

Date of Conviction (MM/YYYY)

Type of Vehicle Operating

Personally Operated Vehicle (POV)

Commercial Motor Vehicle (CMV)

Conviction Type

Additional Explanation:

Supporting Documents

Browse...

Maximum size 10MB

Additional Convictions

Add Any Additional Conviction Details In The Box Below

Date of Conviction, Type of Vehicle Operating, Conviction Type

TRAFFIC ACCIDENTS

Do you have ANY vehicle accidents within the last 5 years? (required)

Yes

Traffic Accident 1 (If Applicable)

Date of Accident (MM/YYYY)

Accident Type

Vehicle Type

Personally Operated Vehicle (POV)

Commercial Motor Vehicle (CMV)

DOT Recordable?

Yes

Preventable/Non-Preventable?

Additional Explanation

Supporting Documents

Browse...

Maximum size 10MB

Traffic Accident 2 (If Applicable)

Date of Accident (MM/YYYY)

Accident Type

Vehicle Type

Personally Operated Vehicle (POV)

Commercial Motor Vehicle (CMV)

DOT Recordable?

Yes

Preventable/Non-Preventable?

Additional Explanation

Supporting Documents

Browse...

Maximum size 10MB

Traffic Accident 3 (If Applicable)

Date of Accident (MM/YYYY)

Accident Type

Vehicle Type

Personally Operated Vehicle (POV)

Commercial Motor Vehicle (CMV)

DOT Recordable?

Yes

Preventable/Non-Preventable?

Additional Explanation

Supporting Documents

Browse...

Maximum size 10MB

Additional Accidents

Add Any Additional Accident Details In The Box Below

Date of Accident, Accident Type, Vehicle Type

EMERGENCY CONTACT INFORMATION

Name (required)

Phone Number (required)

Relationship (required)

CONFIRMATION & SUBMISSION

I confirm that the information submitted via this 'BMS Unlimited Online Application' is true and correct to the best of my knowledge.

Signature (Type Full Name) (required)

Date (required)

Please enter the last four digits of your Social Security number to confirm your submission (required)

This field should be left blank

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