Contact form 7 step demo

General Information


Full Legal Name

Address

Address 2

City

State

Zipcode

Phone Number

Alternate Phone Number

Email Address






Position & Work Related Information


Are you eligible to work in the USA?

Are you at least 18 years of age?

Please Select Amount of Experience in Related Field

Expected Rate of Pay (Hourly or Aunnual)

Date Available to Start Working

How did you hear about Logisticize, LLC?

Have you ever worked for Logisticize, LLC?






Criminal History


Have you ever been convicted for something other than minor traffic violation?:

What Date Were You Convicted?

City of Conviction

State

Type of Conviction

Additional Conviction Comments


Previous Employment


Name of Employer

Your Job Title

Your Duties

Date Started

Employed Until

Pay Rate

Reason For Leaving

Supervisor's Name

Supervisor's Number

May We Contact This Employer?



Previous Employment


Name of Employer

Your Job Title

Your Duties

Date Started

Employed Until

Pay Rate

Reason For Leaving

Supervisor's Name

Supervisor's Number

May We Contact This Employer?



Previous Employment


Name of Employer

Your Job Title

Your Duties

Date Started

Employed Until

Pay Rate

Reason For Leaving

Supervisor's Name

Supervisor's Number

May We Contact This Employer?



Driving Record & License Information


Endorsements
Double or Triple TrailersTank VehiclesPassenger VehiclesHazardous Materials

Has your Permit, CDL, or privilege to operate a motor vehicle ever been denied, suspended, or revoked or cancelled?

Additional Comments



Collisions


Date

Collision Details

State

Number of Injuries

Number of Fatalities

Hazardous Material Spill



Collisions


Date

Collision Details

State

Number of Injuries

Number of Fatalities

Hazardous Material Spill



Collisions


Date

Collision Details

State

Number of Injuries

Number of Fatalities

Hazardous Material Spill



Traffic Convictions & Forfeitures


Date

State

Violation

Penalty

Commercial Vehicle



Traffic Convictions & Forfeitures


Date

State

Violation

Penalty

Commercial Vehicle



Traffic Convictions & Forfeitures


Date

State

Violation

Penalty

Commercial Vehicle



Driving Experience


Straight Truck

Date:
to

Approximate Miles Driven



Tractor & Semi Trailer

Date:
to

Approximate Miles Driven



Other

Date:
to

Approximate Miles Driven



List Commodities Hauled



Education (Most Recent First)


Name of School

Diploma/Degree

Completion

Achievements, Awards, Volunteering, and/or Comments



Education


Name of School

Diploma/Degree

Completion

Achievements, Awards, Volunteering, and/or Comments



Education


Name of School

Diploma/Degree

Completion

Achievements, Awards, Volunteering, and/or Comments




Military Information


Military Branch

Specialty

Rank

Time Served

Discharge Date

Achievements, Awards, Volunteering, and/or Comments




Questionnaire


Why Do You Want To Work For Logisticize, LLC?

Additional Comments






Do you have relatives working for Logisticize, LLC?

Relative's Name

Relative's Phone Number

Relationship to Relative



Relative's Name

Relative's Phone Number

Relationship to Relative



Relative's Name

Relative's Phone Number

Relationship to Relative



Reference


Full Name

Title

Company

Address

Address 2

City

State

Zipcode

Phone Number

Relationship to Reference



Reference


Full Name

Title

Company

Address

Address 2

City

State

Zipcode

Phone Number

Relationship to Reference





I hereby certify that all the information given is true and complete, and agree that any false information given during the hiring process, or after employment may be grounds for denial of employment or immediate discharge if employed.

The companies, schools and people listed have my permission to give out lawful information concerning me, and are released from all liability on my part.






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