The purpose of this application is to determine whether or not the applicant is qualified to operate motor carrier equipment according to the requirements of the Federal Motor Carrier Safety Regulations and of Viking Land Transportation.
Instructions to Applicant
Please answer all questions. If the answer to any question is "No" or "None", do not leave the item blank, but write "No" or "None".
3 Years Previous Address:
*The Age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.
I Worked Here
Give a COMPLETE RECORD of ALL employment for the past 10 year, including any unemployment or self employment and all commercial driving experience for the past ten years.
As a condition of employment with Viking Land (Motor Carrier), Commercial Motor Vehicle (CMV) Driver Applicants must submit to a pre-employment controlled substances test as required by the Federal Motor Carrier Safety Regulations (FMCSR) Section 3B2.301. A motor carrier must receive verified negative test results for the applicant driver for the applicant to be eligible for employment.
If you are hired, you will be subject to laws requiring additional controlled substances and alcohol testing on you under numerous situations including, but not limited to, the following:
Post-Accident - Section 382.303
Random - Section 382.305
Reasonable Suspicion - Section 382.307
Return to Duty - Section 382.309
Follow-up Section 382.311
All controlled substances and alcohol testing will be conducted in accordance with Parts 40 and 382 of the FMCSR.
A driver who tests positive for a controlled substance(s)and/or alcohol test, will be immediately removed from a safety sensitive position as required by Part 382 of the FMCSR. Federal law prohibits a driver from returning to a safety sensitive position for any motor carrier until and unless the driver completes the Substance Abuse Professionals (SAP) evaluation,referral and educational/treatment process, as described in FMCSR Part 40,Subpart 0.
TO BE READ AND SIGNED BY THE APPLICANT
It is agreed and understood that any misrepresentation given above shall be considered an act of dishonesty.
It is further agreed and understood that Viking Land may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant release employers and persons named herein from all liability for any damages on account of his furnishing such information.
It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91 - 508,1 have been told that this investigation may include an Investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.
I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.
It is agreed and understood that this application for qualification in no way obligates Viking Land to employ the applicant.
It is agreed and understood that if qualified, the driver may be on a probationary period during which time he may be disqualified without recourse.
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.
List three Persons for reference, other than relatives, who have knowledge of your safety habits.
Tractor - Two Trailers
(Other than parking violations)