Aim NationaLease Driver Application


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Driver Application

Aim Dedicated Logistics Driver Application

Personal Information

First Name :

Last Name :

Address 1 :

Address 2 :

City / State / Zip Code :

/ /

email address :

Social Security Number :

Date of Birth :

(Minimum 23 years of age)

Years of CDL driving experience :

(Minimum 2 years of experience)

Which Class?

Phone Number :

Pager Number :

Best time to call :

Which of the following types of positions would you be interested in?

	Local (home same day)
	Regional (500 mile radius)
	Over the Road (out more than one night)
	Yard Jockey

	Drop and Hook
	Palletized Freight
	Hand Unload (Multi-stop Delivery)

	Food service
	Steel / Aluminum
	General Commodities

	Straight Truck (Class B)
	Dry Van (Class A)
	Reefer Van (Class A)
	Flatbed / Covered Wagon (Class A)

License Information

Number of moving violations in the past 3 years :

Number of accidents in the past 3 years :

Has your license ever been
suspended or revoked?

Yes No

If yes, when

Why?

Have you ever been convicted of a DUI/DWI?

Yes No

If yes, when?

Have you ever been convicted
of reckless operation?

Yes No

If yes, when?

Have your ever been convicted of
a misdemeanor or felony?

Yes No

If yes, explain :

Have you ever tested positive for drugs/alcohol
for employment testing?

Yes No

Do you have any charges pending?

Yes No

yes, explain :

Do you have a current DOT physical?

Yes No

Military service?

Yes No

Type of discharge :

Do we have your authorization to run an MVR?

Yes No

License Number :

State :

CDL :

A B

Hazardous Materials :

Yes No

Employment History

Current Employer :

Dates Employed :

From :

To :

Address 1 :

Address 2 :

City / State :

Contact :

Phone :

Fax :

Job Description :

Equipment Driven

OTR, Regional or Local?

Reason for leaving :

May we contact your current employer?

Yes No

Previous Employer 1 :

Dates Employed :

From :

To :

Address 1 :

Address 2 :

City / State :

Contact :

Phone :

Fax :

Job Description :

Equipment Driven :

OTR, Regional or Local?

Reason for leaving :

Previous Employer 2 :

Dates Employed :

From :

To :

Address 1 :

Address 2 :

City / State

Contact :

Phone :

Fax :

Job Description :

Equipment Driven :

OTR, Regional or Local?

Reason for leaving :

Do you accept the information in this application for employment to be true ? Yes No

Your Initials

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