I certify that I have only one (1) license, bearing number
issued by the State of
By signing this document, I accept the provisions of the 1986 Motor Carrier Act which states that as a commercial driver operating in Intrastate or Interstate commerce of 26,000 GVW weight, I shall bear only one (1) license in the state in which I am a permanent resident.
Bulldog Hiway Express is an equal opportunity employer. We are committed to providing equal opportunity to all applicants and employees in full compliance with all applicable state and federal laws prohibiting discrimination on the basis of race, color, age, sex, sexual orientation, religion, national origin, disability, veteran status or any other class protected by applicable state or federal law.
I hereby authorize Bulldog Hiway Express to do a complete background investigation in accordance with state and federal laws. I authorize release of any information, including all information related to my alcohol and controlled substances testing and training records required by the Federal Highway Administration (FHWA) 49 CFR Parts 391 or 382, by any past or current employers. I hereby release all such persons from any liability or damages. I consent to the procurement and use of any consumer reports deemed necessary by Bulldog Hiway Express or its subsidiaries in their consideration of my employment.
I also understand that I must notify the “State of License” and the carrier, in writing, of all traffic violations within thirty (30) days of that violation.
I hereby certify 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. I understand that false, misleading or incomplete information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I understand that I am applying for at-will employment, and that if I am hired Bulldog Hiway Express has the right to terminate my employment at any time with or without cause or notice. I understand that no manager or representative of the company, other than the president or his designee, has any authority to enter in to any agreement for employment for any specified period of time or make any agreement contrary to the foregoing either now, in the past, or in the future. I further understand that such an agreement must be in writing and signed by the president for it to be binding on either myself or the company. I further understand that this statement supersedes any prior oral or written understanding and bars any future oral understanding to the contrary.
* Have you ever lost your driving privileges?:
What other state(s) have you possessed a license in during the past 5 years?
Military Service Record
Have you ever served in the US Armed Forces?:
* Employment Position Desired:
All applicants must list at least 3 years of work history, experienced drivers need to list that last 10 years of experience. Start with your present or last job, including military service assignments and volunteer activities. Please exclude organization names which indicate race, color, religion, sex or national origin. You must give complete names and addresses.
* Are you currently employed?:
* If so, may we contact your present employer?:
* Do you currently drive a tractor trailer full-time?:
Previous Employer 1
May we contact this employer?:
Previous Employer 2
May we contact this employer?:
Please list below three persons not related to you whom you have known for at least three years that we may contact for references.
* Did you attend a truck driving training school?:
Motor Vehicle Driver's Certification
* Have you ever been convicted of a crime?:
Retype the numbers below: