01
Personal Information
Legal name and contact details as they appear on your CDL
Applicant Name
Required field
Required field
Contact Information
Required field
Enter a valid email address
Current Address
Required field
Required
Required
Required
Provide 3 years of address history below if less than 3 years here
Date of Birth & Eligibility
Required — must be 21+ for interstate driving
Full SSN collected on hire for tax/background purposes
Required
02
License & Certifications
CDL class, endorsements, and all license numbers held
Commercial Driver's License
Required
Required
Required
Required — DOT Medical Certificate required
Endorsements & Restrictions
Other Licenses (if applicable)
FMCSA Requirement: You must list all motor vehicle operator's licenses or permits held in any state in the past 3 years. Failure to disclose may be grounds for rejection or termination.
License #1
03
Driving Experience
Equipment types, mileage, and specialized experience
Equipment Experience
Equipment Type #1
Driving Capabilities
04
Employment History
10 years required by FMCSA — start with most recent employer
FMCSA § 391.21 Requirement: Federal regulations require a 10-year employment history. You must account for any gaps in employment. Falsification is grounds for immediate disqualification.
Employer #1 — Most Recent
05
Accident & Violation History
3-year history required. Accurate reporting protects you and others.
Note: Failure to disclose accidents or violations that appear on your motor vehicle record (MVR) will result in automatic disqualification. An MVR will be obtained.
Accident Record — Past 3 Years
Traffic Violations & Convictions — Past 3 Years
Drug & Alcohol History
06
Disclosures & Signature
Review, certify accuracy, and sign your application
FMCSA Pre-Employment Disclosures
Certification & Authorization
Sign Here
Required
This application complies with FMCSA §391.21 and DOT 49 CFR Part 40 requirements.
Information collected is used solely for employment screening purposes.
Information collected is used solely for employment screening purposes.
Application Submitted
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