CAREERS WITH FLORIDA ROCK & TANK LINES

Company Driver Application Form All Fields Required

*****Disclaimer*****
Upon completion of this form, Florida Rock & Tank Lines, Inc. will contact you, and if qualified, your MVR and DAC will be pulled and examined. By submitting this form, you agree to these conditions and grant permission to Florida Rock & Tank Lines, Inc. to review driving, employment and safety records or information.
Statement"Please indicate which terminal you are interested in. Please note that you must live within 40 miles of the terminal you are applying for"

Terminal: How did you Hear About Us?
Driver's Contact Info
First Name: Middle Name: Last Name:
Social Security # : Birth Date (MM/dd/YYYY): Current Age:
Contact Email: Address: City/State:
Country: Zip:
Home Phone: Cell Phone:
Qualifications
Driver's License # : State:
Expiration Date(MM/dd/YY): Endorsement:
Other CDL's Previously Held (License #): TWIC Card:
Expiration Date: State:
Other Information
1. Do you have at least 12 Months of Verifiable Tractor-Trailer Experience with in the Last 3 Years?
2. How many Total Years for Verifiable Tractor/Trailer Experience do you have?
3. Do you have a Certificate from a Truck Driving School ?
4. Have you had a DWI or DUI conviction within the past 10 years?
5. Have you had a Reckless Driving conviction within the past 3 years?
6. Has your current license or any license ever been suspended or revoked?
If Yes, When?
What was it for?
7. How many moving violations (everything but parking tickets) have you had in the past 5 years?
8. How many accidents (whether your fault or not) have you been involved in in the past 5 years?
9. How many employers have you had in the past 3 years?
10. Are you presently employed?
11. Have you ever been convicted of a felony?
If Yes, When?
What was it for?
12. Have you ever tested positive on a drug test OR tested more than .02 BAC in an alcohol test?
Please List Previous Employers w/ Phone numbers and Dates of Employment
PLEASE LIST ALL EMPLOYMENT AND GAPS OF UNEMPLOYMENT FOR THE PAST 10 YEARS
Most Recent Employer
Resigned
Discharged
Unemployed
Reason For Change
2nd Most Recent Employer
Resigned
Discharged
Unemployed
Reason For Change
3rd Most Recent Employer
Resigned
Discharged
Unemployed
Reason For Change
4th Most Recent Employer
Resigned
Discharged
Unemployed
Reason For Change
5th Most Recent Employer
Resigned
Discharged
Unemployed
Reason For Change
6th Most Recent Employer
Resigned
Discharged
Unemployed
Reason For Change