Drivers Application | Villa Park Trucking

ONTARIO (800) 734-8734 | PORTERVILLE (559) 788-6390

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Drivers Application

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REQUIRED FORMS & DOCUMENTS
Applications will not be reviewed without a copy of license and an MVR. Please upload these documents below or if you would prefer to email the required documents listed below please send to hr@vptrucking.com

Applicants are considered without regard to race, creed, color, sex, religion, age, national origin, or disability.
Document Submission Options*
- I would like to upload my license and MVR to this application
- I would like to email my license and MVR to HR
Motor Vehicle Records*
Valid Drivers License*
DRIVER APPLICATION FOR EMPLOYMENT
How you heard about this position?*
- VPT Website
- Craigslist
- VPT Driver Referral
- Other
Driver Name
Please explain:
Name of Carrier*
Today's Date*
Date Format: MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code

DRIVER DETAILS
Name*
First Middle Last
Social Security Number*
Date of Birth*
Date Format: MM slash DD slash YYYY
Email*
Phone*
Current Address*
Street Address Address Line 2 City State ZIP Code
Previous Address (last 3 years)
Street Address Address Line 2 City State ZIP Code
Previous Address (last 3 years)
Street Address Address Line 2 City State ZIP Code
In Case of Emergency Notify:*
Emergency Contact Phone Number*
Do you have full knowledge of the Federal Motor Carrier Safety Regulations?*
- Yes
- No
Are you currently employed?*
- Yes
- No
When will you be available to start?*
Have you ever worked for this company?*
- Yes
- No
If yes, when?*
Are you a citizen of the United States?*
- Yes
- No
If no, are you authorized to work in the U.S.?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
If yes, please explain:*

EXPERIENCE & QUALIFICATIONS
Valid Driver’s License No.*
State Issued*
State
Expires On*
Date Format: MM slash DD slash YYYY
License Type (CDL Class A, Class 1, Etc.)*
List CDL endorsements*
Have you ever been denied a permit, license, or privilege to operate a commercial motor vehicle?*
- Yes
- No
If yes, please explain:
Has your license, permit, or privilege been suspended or revoked?*
- Yes
- No
If yes, please explain:
DRIVING EXPERIENCE
Do you have Straight Truck Experience?*
- Yes
- No
Straight Truck (please list type of equipemnt)*
Years of Experience*
States you have driven in*
Do you have Tractor Truck Experience?*
- Yes
- No
Tractor Truck (please list type of trailer and power unit)*
Years of Experience*
States you have driven in*
Other (please specify)
Years of Experience
States you have driven in

ACCIDENT RECORD
Date
Date Format: MM slash DD slash YYYY
Nature of Accident (Overturn, Jack Knife, etc.)
Number of Fatalities
Number of Injuries
Type of Vehicle
- Commercial Vehicle
- Personal Automobile
Date
Date Format: MM slash DD slash YYYY
Nature of Accident (Overturn, Jack Knife, etc.)
Number of Fatalities
Number of Injuries
Type of Vehicle
- Commercial Vehicle
- Personal Automobile
Date
Date Format: MM slash DD slash YYYY
Nature of Accident (Overturn, Jack Knife, etc.)
Number of Fatalities
Number of Injuries
Type of Vehicle
- Commercial Vehicle
- Personal Automobile
TRAFFIC CONVICTIONS & FORFEITURES
Please list any traffic convictions and forfeitures for the past three years (other than parking)
State Committed
State
Date
Date Format: MM slash DD slash YYYY
Charge
Penalty
Type of Vehicle
- Commercial Vehicle
- Personal Automobile
State Committed
State
Date
Date Format: MM slash DD slash YYYY
Charge
Penalty
Type of Vehicle
- Commercial Vehicle
- Personal Automobile
State Committed
State
Date
Date Format: MM slash DD slash YYYY
Charge
Penalty
Type of Vehicle
- Commercial Vehicle
- Personal Automobile

EMPLOYMENT
Company*
Phone Number*
Address*
Street Address Address Line 2 City State ZIP Code
Job Title*
From*
Date Format: MM slash DD slash YYYY
To*
Date Format: MM slash DD slash YYYY
Reason for Leaving*
May we contact for a reference?*
- Yes
- No
Company
Phone Number
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason for Leaving
May we contact for a reference?
- Yes
- No
Company
Phone Number
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason for Leaving
May we contact for a reference?
- Yes
- No

EDUCATION
High School*
Address*
Street Address Address Line 2 City State ZIP Code
From*
Date Format: MM slash DD slash YYYY
To*
Date Format: MM slash DD slash YYYY
Did you graduate?*
- Yes
- No
College
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Additional Training & Qualifications

PREVIOUS EMPLOYEE INFORMATION & RELEASE
Name*
First Middle Last
Social Security Number*
Date of Birth*
Date Format: MM slash DD slash YYYY
Valid Driver’s License No.*
State Issued*
State
I hereby authorize*
to release the following requested information to CDTA, A Part of National Compliance Solutions Inc., 1011 Camino del Rio S #200, San Diego, CA 92108. (888)-908-2381. for the purpose of investigation to qualify me to drive a commercial motor vehicle as required by the U. S. Department of Transportation & Federal Motor Carrier Safety Regulations Parts 382, 391, 392 & 49 CFR Part 40. I understand that information to be released in Section 2 by my previous employer is limited to the following DOT-regulated testing items:

1. Alcohol test with results of 0.04 or higher; 2. Verified positive drug tests; 3. Refusals to be tested; 4. Other violations of DOT agency drug and alcohol testing regulations; 5. Information obtained from previous employers of a drug and alcohol rule violation; 6. Documentation, if any, of completion of the return-to-duty process following a rule violation.
Signature*
Today's Date*
Date Format: MM slash DD slash YYYY

GENERAL BACKGROUND INFORMATION RELEASE
This information will, in whole or in part, be obtained from CDTA, A Part of National Compliance Solutions Inc., 1011 Camino del Rio S #200, San Diego, CA 92108. (888)-908-2381. These reports will include information as to my work habits, performance and experience along with reasons for termination of past employment from previous employers. Further, I understand that you will be requesting information from various federal, state and other agencies which maintain records concerning my past activities relating to my driving, credit, civil and other experiences as well as notable criminal activity & claims involving me in the files of insurance companies. This release may also be used to obtain worker's compensation and education records.

By signing below, I also acknowledge that I have read and understand the summary of my rights under The Fair Credit Reporting Act. Pub. L. 111-203, H. R. 4173
Signature*
Today's Date*
Date Format: MM slash DD slash YYYY

PREVIOUS EMPLOYMENT VERIFICATION
I authorize Villa Park Trucking, Inc, and its agents or representatives the right to investigate all references and to secure additional information about my employment background, and information related to my controlled substance and alcohol testing and/or results pursuant to Regulation 49 CFR 391.23d & e. I further authorize VPT and its agents or representatives’ permission to receive consumer reports regarding my employment history, criminal background, and worker compensation claims from third party agencies such as CDTA or other agencies, which may be requested by VPT to provide such information. I hereby release from all liability for damages VPT and its agents or representatives for seeking such information and all other persons, corporations or organizations for furnishing such information:
Name*
First Middle Last
Social Security Number*
Date of Birth*
Date Format: MM slash DD slash YYYY
Signature*
Today's Date*
Date Format: MM slash DD slash YYYY

SOUTHERN CALIFORNIA TERMINAL

2301 E. Francis Street, Ontario, CA 91761

PHONE: (800) 734-8734

FAX: (909) 947-5454

CENTRAL CALIFORNIA TERMINAL

23856 Avenue 124, Porterville, CA 93257

PHONE: (559) 788-6390

FAX: (559) 788-6392

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