Thank you for your interest in UZ Trans, Inc.. To apply for a driving position, please complete our online application for employment. Incomplete information will delay the processing of your application or prevent it from being submitted. In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
To fill out this form, you will need to know the following:
  • Social Security Number
  • Home address history for the past 3 years
  • Current driver license number and driver license history for the past 3 years
  • Employment history up to 10 years
  • History of traffic accidents, violations and/or convictions from the last 3 years (including DUI or reckless driving conviction and license suspension)
  • Criminal history
  • Military history (if applicable)
To qualify with UZ Trans, Inc., you must meet the following criteria:
  • Must be at least 23 years of age
  • Have CDL Class A
  • 2 years of verifiable commercial truck driving experience
  • Have no moving violations in the past 3 years
  • No preventable DOT recordable accidents in 3 years
  • NO felony convictions in the last 7 years
If you encounter any errors during this process and cannot continue, please contact us at 855-898-7267.
 


Personal information

Date of birth:
Residence address for 3 or more years? YesNo

If No, please list addresses you resided during last years:

From:
To:
Add one more address? YesNo
From:
To:
Add one more address? YesNo
From:
To:
Add one more address? YesNo
From:
To:


General information

Are you legally eligible for employment in the United States? YesNo
Are you currently employed? YesNo
Do you read, write, and speak English? YesNo
Have you ever worked for this company before? YesNo
Have you ever been known by any other name? YesNo


Driving experience

For each class of equipment, enter type of equipment (van, reefer, tank, etc.), start and end dates, and approximate number of total miles. If no experience in a class, enter "NONE".




Equipment (OWNER/OPERATORS ONLY)


Equipment Description (Tractor):




Education




Personal references


List name, address, city, state, phone number, and relationship:




License Information

License expiration:
Physical expiration:
Is this your current driver license? YesNo
Is this a commercial driver license? YesNo
Endorsements: NoneOtherTankerDoubles / TriplesX EndorsementHazMat

If you had any commercial license during last 3 years, please list below.




Employment


Please list your employers for last ten years starting with most recent / current employer, including the companies you had orientation and drug testing done.

Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo
Add one more employer? YesNo
Start date:
End date:
Were you terminated/discharged/laid off? YesNo
Is this your current employer? YesNo
May we contact this employer at this time? YesNo
Did you operate a commercial motor vehicle? YesNo

If yes, please, share following information:

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? YesNo
Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? YesNo


Have you attended a Driver Training school? YesNo

If yes, please share details:

Start date:
End date:
Did you graduate? YesNo
Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while attending this truck school? YesNo
Did you perform any safety sensitive functions at this truck school, regulated by DOT, and subject to drug and alcohol testing? YesNo

Have you attended a school (not related to truck driving) in the last 3 Years? YesNo

If yes, please share details:


Have you been unemployed at any time within the last 3 years? YesNo

If yes, please share details:

Start date:
End date:


Motor Vehicle Record

Has any license, permit or privilege ever been denied, suspended or revoked for any reason? YesNo
Have you ever been convicted of driving during license suspension or revocation, or driving without a valid license or an expired license, or are any charges pending? YesNo
Have you ever been convicted for any alcohol or controlled substance related offense while operating a motor vehicle, or are any charges pending? YesNo
Have you ever been convicted for possession, sale or transfer of an illegal substance (including but not limited to, marijuana, amphetamines, or derivatives thereof) while on duty, or are any charges pending? YesNo
Have you ever been convicted of reckless driving, careless driving or careless operation of a motor vehicle, or are any charges pending? YesNo
Have you ever been convicted of reckless driving, careless driving or careless operation of a motor vehicle, or are any charges pending? YesNo

Have you had any moving violations or traffic convictions in the past 3 Years? YesNo

If yes, please share details:

Violation date:
Were you in a Commercial Vehicle? YesNo
Penalty / Fine (Check all that apply) FineSuspensionRevocationCommunity serviceOther


Accident history

Were you involved in any accidents/incidents with any vehicle in the last 3 years (even if not at fault)? YesNo

If yes, please enter detailed information about this accident below, whether the accident was chargeable, recordable, reportable, or your fault:

Violation date:
Hazmat Accident / Incident YesNo
Was the vehicle towed away? YesNo
Were you in a commercial vehicle? YesNo
Was this a Department of Transportation recordable accident? YesNo
Were you at fault? YesNo
Were you ticketed? YesNo


Criminal record

Have you ever been convicted of a crime? YesNo
Do you have any deferred prosecutions? YesNo
Do you have criminal charges pending? YesNo
Have you ever pled "guilty" to, been convicted of, or pled "no contest" to a felony? YesNo
If you have any felony convictions, do you currently hold a minister's permit to enter or exit Canada? YesNo
Have you, within the last five years, pled "guilty" to, been convicted of, had prosecution deferred in connection with, or pled "no contest" to a misdemeanor? YesNo

I acknowledge that I have read and understand the Summary of Rights.
I acknowledge that I have read and understand the above Important Notice of Rights.
I acknowledge that I have read and understand the above Important Notice of Rights.
I represent that I understand and agree to the above and that I intend to execute this document by electronic signature in checking this box


DOT EMPLOYMENT, SAFETY AND DRUG/ALCOHOL VERIFICATION REQUEST


Please list all DOT-regulated employers you have applied with and/or worked for in a safety-sensitive function during the previous three years.

I represent that I understand and agree to the above and that I intend to execute this document by electronic signature in checking this box

This certifies 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.

Please use your mouse to sign your name in the rectangle below (by clicking the left mouse button in the rectangle and dragging the mouse while holding the button down). Click Submit when finished.