Driver Application

Application for Employment - Driver of Commercial Vehicle

Trinity Sales L.L.C. * 2225 S. West Street * Wichita, Kansas 67212

Legal Name

DOB

Address

Phone

Previous Address(es) of last 3 years

Motor Vehicle License State and Number

Expiration Date

SS#

Driving Experience includes what types of vehicles?

Please list all motor vehicle accidents involved in the past 3 years including date, nature of accident, personal injuries or fatalities:

List all violations of motor vehicle laws or ordinances (other than parking violations) convicted of or forfeited bond/collateral during previous 3 yrs., including dates & locations:

If no violations are listed above, I certify that I have not been convicted or forfeited bond or collateral on account of any violation required to be listed.

Driver’s Signature

Date of Certification

Previous Employers (past 7 years)

Name

Address

Date Employed

Reason for leaving

Name 2

Address 2

Date Employed 2

Reason for leaving 2

Name 3

Address 3

Date Employed 3

Reason for leaving 3

Has your motor vehicle license ever been revoked or suspended ?

If yes, give dates and reason for revocation or suspension.

I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Date

Applicant’s Signature

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Driver Application