Watts (800)729-8946	Local (763) 428-4969
Fax (763) 428-4979	Brokerage (800) 844-8924

21840 Industrial Court, Suite 100, Rogers, MN 55374

Welcome to our on-line driver employment application. Please fill out the application and send it to us.
Last Name
First Name
Middle Initial
Home Address
Home City
State
Zip Code
Home Phone	/-
Cell Phone/Pager	/-
Month of Birth Day of Birth Year of Birth
CDL Number
State
CDL Expiration Month DayYear
CDL Issue Month DayYear
Has your CDL ever been revoked?
Social Security Number
Years of driving experience
Number of tickets in the last three years
Number of accidents in the last three years
Number of licenses held in the last three years
Endorsements (check the ones you have)		HAZ-MAT Doubles/Triples Tanks


Present or Last Employer/ Driver Training Program
	Name
	Address
	City, State, Zip
	Phone (include area code)
	From Month Day Year
	To Month Day Year
	Reason for leaving
	Number of states
Position held


Next to Last Employer/ Driver Training Program
	Name
	Address
	City, State, Zip
	Phone (include area code)
	From Month Day Year
	To Month Day Year
	Reason for leaving
	Number of states
Position held


Third to last employer/ Driver Training Program
	Name
	Address
	City, State, Zip
	Phone (include area code)
	From Month Day Year
	To Month Day Year
	Reason for leaving
	Number of states
Position held
Type of driving assignment desired:

Please read the following and press "I accept" only if you agree.
I certify that I personally completed this application for the purpose of employment and that all the information herein is true and correct. I understand that the information in this form will be used and that prior employers will be contacted for purposes of investigation as required by 391.23 of the Motor Carrier Safety Regulations, and that a complete background investigation will be done in accordance with federal and state laws.