Driver Form Driver InformationFirst NameMiddle NameLast NameDate of BirthAgeDriver AddressAddressAddress Line 1Address Line 2CityStateZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweContact InformationContact NumberEmail AddressEmergency ContactEmergency PhoneEmergency Email I have read and agree to the T & CPreviousNextDriver’s Questionnaire SELECT ALL ANSWERS THAT PERTAIN TO YOU FOR EACH QUESTION IN THE ORDER FROM MOST IMPORTANT TO LEAST IMPORTANT.Are you willing to re-locate? Yes NoWhere would you re-locate to?OregonWashingtonCaliforniaIdahoNevadaColoradoWyomingOtherCommentIf hired when are you available to start this position?TodayTomorrow5 DaysOne Week10 Days2 WeeksMore Than 2 WeeksOtherCommentWhat do you prefer best Local, Regional or Over the Road driving?LocalRegionalOver the Road drivingOtherCommentHow do you preferred to be paid?HourlyPercentageBy the mileOtherCommentWhat are you looking for in a Benefit Package?WagesProfit SharingBonusesInsuranceSick LeaveOvernight Per Diem401K MatchingOtherCommentWhy are you looking to change companies?AdvancementHigher WageBenefitsMore Family TimeHome Every NightWeekends OffOtherCommentWhat is your preferred annual income?$10,000 to $25,000$25,000 to $35,000$35,000 to $50,000$50,000 to $75,000$75,000 or moreOtherCommentWhat were you looking for when you chose a career in commercial driving?Job SecurityMoneyCareer OptionsBenefitsFreedomTo See The CountryOtherCommentHow did you obtain your CDL?Company TrainingCDL SchoolCDL DriverSelf TaughtOtherCommentHow much experience do you have driving?1 Yr or Less2 Yrs3 Yrs4 to 6 Yrs6 to 9 Yrs10 Yrs or MoreOtherCommentWhat endorsements do you have?(H)Hazardous Materials(N)Tank Vehicle(P)Passenger(T)Double/Triples(X)Tanker/Hazardous MaterialsOtherCommentWhat type of employee are you?Team playerLoyalEfficientGreat Work EthicGets Things DoneReliableHigh AchieverOtherCommentPreviousNextDriving Personality Questions SELECT ALL ANSWERS THAT PERTAIN TO YOU FOR EACH QUESTION IN THE ORDER FROM MOST IMPORTANT TO LEAST IMPORTANT.How would you describe your driving record?ExcellentAbove AverageAverageBelow AverageOtherCommentWhy?What do you think is the primary job of a Commercial driver?Deliver Goods to CustomersInspecting Vehicles For Mechanical IssuesSafety IssuesPreventative maintenancePlanning Best RoutesMeeting Delivery SchedulesOtherCommentHave you earned any driving awards? Yes NoIf Yes, What are they?Safety Bonus or AwardMileage BonusEmployee of the MonthEmployee of the YearOtherCommentDo have plans for advancement? Yes NoIf Yes, What are they?Shop MechanicDispatchOfficeManagementSalesOwner OperatorOtherCommentWhat motivates you to get a load delivered on time and safely?Personal AccomplishmentCompany RecognitionJob DutiesOtherCommentWhat are your strengths?SkillsTraffic AwarenessMechanical AwarenessCommunicationAttitudeWork EthicOtherCommentWhat are your Weaknesses?SkillsTraffic AwarenessMechanical AwarenessCommunicationAttitudeWork EthicOtherCommentWhat are your hobbies and things you like to do on your off time?FishingHuntingWatching SportsFamily TimeWoodworkingRelaxingYard WorkOtherCommentWhat may cause you to miss work?SicknessDr. AppointmentFamily Issue or EmergencyTo Tired From Long HoursCar TroubleDeath of Love OneOtherCommentHow do you stay focused on the highway when driving?Pre-Planed Play ListResting When NeededNo MultitaskingRoute is GPS'dCommit To No Phone UsageOtherCommentHave you ever caused an accident? Yes NoWhat caused the accident(s)?Cargo Load SiftingMaintenance IssueFollowing to CloseDistracted DrivingD.U.I.Driver FatigueSpeedingOtherCommentWhat’s the most important steps to take if you are in an accident?Notify Police CompanySecure The Scene. Render First Aid if NeededObtain Witness Contact InformationCheck Everyone For InjuriesGet a Medical EvaluationCall DispatchCall 911OtherCommentDoes being stuck in traffic stress you out?YesBut Doesn't Affect My DrivingI Get Anxious Need a BreakNoJust Part of the JobOtherCommentHow do you deal with late loads because of traffic or mechanical issues?Contact Customer to RescheduleContact Dispatch to Contact CustomerMake Up Time by Speeding SlightlyContinue After being SlowedOtherCommentIf you received incorrect information from dispatch how do you handle it?Call Dispatch to Correct the MistakeCall Dispatch and ComplainCall General Manager to ComplainOtherCommentHow do you keep in good standings with company customers?Always Be Friendly and PersonableNever Speak to ThemSearch them out to Say HelloOtherCommentWhat would you do if someone that you were working with was stealing?Keep to MyselfTell the Other Drivers About itTell ManagementConfront the DriverOtherCommentWhat vehicle Manufacturers have you driven?PeterbiltKenworthVolvoFreightlinerWester StarMackOtherCommentWhat transmissions have used?Automatic15 Speed13 SpeedOtherCommentWhat Trailers have Pulled?ContainersDoubles/TriplesTankerCurtain VanFlatbedDry VanOtherComment All entries on the questionnaire are true to best of my knowledge Previous
