Job Application | Hauser Investments

Date *

today's date

Name *

First

Middle

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone

Date of Birth

EMERGENCY CONTACT

Emergency Contact Name *

First

Last

Relationship to Candidate

Emergency Contact Phone

Emergency Contact Address

Address Line 1

Address Line 2

City

State

Zip Code

Second Emergency Contact Name *

First

Last

Relationship to Candidate (2nd Contact)

Second Emergency Contact Phone

Second Emergency Contact Address

Address Line 1

Address Line 2

City

State

Zip Code

DRIVER INFORMATION

Are you eligible to lawfully work in the United States? *

Yes
No

Are you at least 18 years of age? *

Yes
No

Are you presently employed or under contract? *

Yes
No

Do you have a former name? *

Yes
No

If Yes, please list former name:

First

Middle

Last

Have you ever been discharged from a place of employment or contract? *

Yes
No

If yes, please explain:

May we contact your current employers? *

Yes
No

NOTE: Federal Motor Carrier Safety Regulations require Fedex Ground / Fedex Home Delivery to make inquires to each of your past employers.

Do you have a current Department of Transportation (DOT) physical?

Yes
No

Last DOT Physical Information

Issued Date:

Expires Date:

Did you qualify?

Yes
No

Physician Name

Medical Facility Address

Address Line 1

Address Line 2

City

State

Zip Code

DRIVER LICENSE INFORMATION

Driver License #

Date Issued

State

Date Expires

Endorsements

Restrictions

RESIDENTIAL ADDRESS HISTORY

Please enter all addresses where you have lived in the last three (3) years, including your present address.

Residential Address (1)

From Date:

Address

Address Line 1

Address Line 2

City

State

Zip Code

To Date:

Additional Entry ↓

Residential Address (2)

From Date:

Address

Address Line 1

Address Line 2

City

State

Zip Code

To Date:

Additional Entry ↓

Residential Address (3)

From Date:

Address

Address Line 1

Address Line 2

City

State

Zip Code

To Date:

DRIVING WORK HISTORY / EXPERIENCE

If you do not have driving work history or experience please answer "NO" on this page and enter your work history on "Non-Driving Employment History".

Do you have driving work history and experience in a Cargo Van, Commercial Truck, other Commercial Vehicle, or CDL Tractor Trailer?

Yes
No

If Yes please enter the information below.

Driving Work History/Experience - Part 1

Vehicle Type

Trailer Type

Employment Start Date

Fuel Type

Trailer Type if Other

Employment End Date

Are you an independent Contractor/Driver:

Yes
No

Employer (List employer name from payroll statements):

Is this your current Employer:

Yes
No

Is the motor carrier name same as employer?

Yes
No

If "NO" please Enter Motor Carrier Name!

NOTE:

If you were employed by an Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.

Motor Carrier Employment Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

Additional Entry ↓

Driving Work History/Experience - Part 2

Vehicle Type

Trailer Type

Employment Start Date

Fuel Type

Trailer Type if Other

Employment End Date

Are you an independent Contractor/Driver:

Yes
No

Employer (List employer name from payroll statements):

Is this your current Employer:

Yes
No

Is the motor carrier name same as employer?

Yes
No

If "NO" please Enter Motor Carrier Name!

NOTE:

If you were employed by an Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.

Motor Carrier Employment Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

Additional Entry ↓

Driving Work History/Experience - Part 3

Vehicle Type

Trailer Type

Employment Start Date

Fuel Type

Trailer Type if Other

Employment End Date

Are you an independent Contractor/Driver:

Yes
No

Employer (List employer name from payroll statements):

Is this your current Employer:

Yes
No

Is the motor carrier name same as employer?

Yes
No

If "NO" please Enter Motor Carrier Name!

NOTE:

If you were employed by an Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.

Motor Carrier Employment Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

Additional Entry ↓

Driving Work History/Experience - Part 4

Vehicle Type

Trailer Type

Employment Start Date

Fuel Type

Trailer Type if Other

Employment End Date

Are you an independent Contractor/Driver:

Yes
No

Employer (List employer name from payroll statements):

Is this your current Employer:

Yes
No

Is the motor carrier name same as employer?

Yes
No

If "NO" please Enter Motor Carrier Name!

NOTE:

If you were employed by an Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.

Motor Carrier Employment Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

NON-DRIVING EMPLOYMENT HISTORY AND UNEMPLOYMENT HISTORY

Please list the period of unemployment in this section. Enter Driving history and Experience in previous section. If Unemployed please fill out two sections of this page.

Do you have Non-Driving employment history?

Yes
No

If Yes please enter this information below and entering necessary details.

List Present and ALL previous Non-Driving employment in the past 10 years with NO gaps and enter any necessary details.

Start with present and work back.

To indicate period of unemployment please enter dates of unemployment and in section of Current Status select unemployed and explain details in the area after that.

Non-Driving Employment History and Unemployment History - Part 1

Employment Start:

Employment End:

Employer: (List employer name from payroll statements)

Employer Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

Additional Entry ↓

Non-Driving Employment History and Unemployment History - Part 2

Employment Start:

Employment End:

Employer: (List employer name from payroll statements)

Employer Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

Additional Entry ↓

Non-Driving Employment History and Unemployment History - Part 3

Employment Start:

Employment End:

Employer: (List employer name from payroll statements)

Employer Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

Additional Entry ↓

Non-Driving Employment History and Unemployment History - Part 4

Employment Start:

Employment End:

Employer: (List employer name from payroll statements)

Employer Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone

Current Status

Ending Job Title

Ending Pay Rate

Frequency

Business Type

Supervisor Name

# of People Supervised

Explain:

SCHOOLING AND TRUCK DRIVER TRAINING DETAILS

Schooling and Truck Driver Training (1)

School Type

Date Started:

Country

Date Finished:

Number of Years Attended

Graduated:

Yes
No

Schooling and Truck Driver Training (1)

School

Zip Code

Contact Name

City

Degree

Contact Phone

State

Major

Contact Email Address

Additional Entry ↓

Schooling and Truck Driver Training (2)

School Type

Date Started:

Country

Date Finished:

Number of Years Attended

Graduated:

Yes
No

Schooling and Truck Driver Training (2)

School

Zip Code

Contact Name

City

Degree

Contact Phone

State

Major

Contact Email Address

LEGAL HISTORY

Have you ever been convicted or pled guilty to a felony under your present or any other name?

Yes
No

Have you ever been convicted or pled guilty to a misdemeanor under your present or any other name?

Yes
No

Do you have any criminal matters pending under your present or any other name?

Yes
No

Comments

DRIVING VIOLATIONS/CITATIONS

Date of Violation

Nature of Violation (If speeding, indicate rate of speed and speed limit):

Driving Violation (1)

Vehicle Type

Country

State

Penalty (Indicate fine and length of suspension):

Points:

Additional Entry ↓

Date of Violation

Nature of Violation (If speeding, indicate rate of speed and speed limit):

Driving Violation (2)

Vehicle Type

Country

State

Penalty (Indicate fine and length of suspension):

Points:

Additional Entry ↓

Date of Violation

Nature of Violation (If speeding, indicate rate of speed and speed limit):

Driving Violation (3)

Vehicle Type

Country

State

Penalty (Indicate fine and length of suspension):

Points:

Additional Entry ↓

Date of Violation

Nature of Violation (If speeding, indicate rate of speed and speed limit):

Driving Violation (4)

Vehicle Type

Country

State

Penalty (Indicate fine and length of suspension):

Points:

ACCIDENT HISTORY

Have you been involved in Any motor vehicle accident in the past 3 years?

Yes
No

If Yes list All accidents you have had while operating ANY TYPE of motor vehicle during the past (3) years below and enter all necessary details.

Date of Accident

Nature of Accident

Describe Extent of damage / injuries including monetary value if applicable:

Accident History (1)

Number of Deaths

Number of Injuries

Vehicle Type

At Fault?

Yes
No

Additional Entry ↓

Date of Accident

Nature of Accident

Describe Extent of damage / injuries including monetary value if applicable:

Accident History (2)

Number of Deaths

Number of Injuries

Vehicle Type

At Fault?

Yes
No

Additional Entry ↓

Date of Accident

Nature of Accident

Describe Extent of damage / injuries including monetary value if applicable:

Accident History (3)

Number of Deaths

Number of Injuries

Vehicle Type

At Fault?

Yes
No

FedEx Contacts and Relatives

Do you know anyone employed or contracted by FedEx Ground or an affiliate company?

Yes
No

If Yes, please enter the person's information and any details below.

FedEx Relative/Contact #1

Name

First

Last

Position

Suffix

Location/Company

Relation

Additional Entry ↓

FedEx Relative/Contact #2

Name

First

Last

Position

Suffix

Location/Company

Relation

Additional Entry ↓

FedEx Relative/Contact #3

Name

First

Last

Position

Suffix

Location/Company

Relation

Additional Entry ↓

FedEx Relative/Contact #4

Name

First

Last

Position

Suffix

Location/Company

Relation

MILITARY SERVICE

Do you have any Military Service?

Yes
No

Military Service Start Date

Military Service End Date

Military Branch

Rank at Discharge

Other

Military Separation Status

Primary Specialty

How did you find out about us?

Select the Referral Source that best describes how you found out about the company.

- If the Referral Source is other, provide the details in Other Referral Source.
- If the Referral Source is Current Contractor, provide the details in Referring Fedex Contractor information selection.

Referral Source

Additional Referral Source

Referral Name

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Apply to Drive with Hauser

EMERGENCY CONTACT

DRIVER INFORMATION

DRIVER LICENSE INFORMATION

RESIDENTIAL ADDRESS HISTORY

DRIVING WORK HISTORY / EXPERIENCE

NOTE:

NOTE:

NOTE:

NOTE:

NON-DRIVING EMPLOYMENT HISTORY AND UNEMPLOYMENT HISTORY

SCHOOLING AND TRUCK DRIVER TRAINING DETAILS

LEGAL HISTORY

DRIVING VIOLATIONS/CITATIONS

ACCIDENT HISTORY

FedEx Contacts and Relatives

MILITARY SERVICE

How did you find out about us?

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