Truck Driver Application

We are always looking for hardworking, dedicated individuals to join our team. We offer excellent benefits and a superior working environment.

Halsey Foodservice provides equal employment opportunity to qualified individuals without regard to race, color, religion, sex, (including pregnancy, childbirth, and related medical conditions), national origin, age, (40 and over), citizenship, physical or mental disability, or status as a disabled veteran of the Vietnam era.

In addition to completing the form below you may . Please ensure that your attachment is in either PDF or Word document format and specify Truck Driver as your job interest in the email.

 

Please fill out all fields of the application. (* Indicates a required field)

Date:
Applicant's Personal Data
*Name:
Present Address:
City:
State:
Zip:
*Phone:
*Email:

 

Accident record for the past three (3) years.
Date of most recent accident:
Nature of Accident (Head-on, Upset, etc.):
Fatalities:
Injuries:
   
Date of next previous accident:
Nature of Accident (Head-on, Upset, etc.):
Fatalities:
Injuries:
   
Date of next previous accident:
Nature of Accident (Head-on, Upset, etc.):
Fatalities:
Injuries:

 

Traffic convictions and forfeitures for the past three (3) years (other than parking violations)
Conviction/Forfeiture 1 Location:
Date:
Charge:
Penalty:
   
Conviction/Forfeiture 2 Location:
Date:
Charge:
Penalty:
   
Conviction/Forfeiture 3 Location:
Date:
Charge:
Penalty:

 

Driver Experience and Qualifications
Driver License 1
State:
License Number:
Type:
Expiration Date:

 

Driver License 2
State:
License Number:
Type:
Expiration Date:

 

Driver License 3
State:
License Number:
Type:
Expiration Date:


 
Have you ever been denied a license, permit, or privilege to operate
a motor vehicle?
  YES    NO
 
Has any license, permit, or privilege ever been suspended or revoked?
  YES    NO
  IF THE ANSWER TO EITHER OF THESE QUESTIONS IS "YES," ATTACH A STATEMENT VIA EMAIL GIVING DETAILS.

 

Driving Experience
Class of Equipment:
Type of Equipment
(Van, Tank, Flat, etc.):
Dates: From   To
Approximate Number of Miles (Total):

 

Class of Equipment:
Type of Equipment
(Van, Tank, Flat, etc.):
Dates: From   To
Approximate Number of Miles (Total):

 

Class of Equipment:
Type of Equipment
(Van, Tank, Flat, etc.):
Dates: From   To
Approximate Number of Miles (Total):

 

List states operated in for last five years:
Show special courses of training that will help you as a driver:
Which safe driving awards do you hold and from whom?

 

Experience and Qualifications — Other
Show any trucking, transportation, or other experience that may help in your work for Halsey Foodservice:
List courses and training other than shown elsewhere in this application:
List special equipment or technical materials you can work with (other than those already shown):

Disclosure and Release Form — Employee Driving Record Information

In connection with my employment (or my application for employment), I hereby give permission to Halsey Foodservice (hereinafter referred to as Employer) to obtain my state driving record (also known as my motor vehicle record or MVR).

I acknowledge and understand that my driving record is a consumer report that contains public record information.

I authorize, without reservation, any party or agency contracted by Employer, to furnish the above-mentioned information.

I understand that I have the right to request a copy of my driving record and to know the source or sources of my driving record, for a two-year period preceding my request.

This authorization shall remain on file by Employer for the duration of my employment, and will serve as ongoing authorization for Employer to procure my state driving record at any time during my employment period.

I understand that Employer may take adverse action affecting my employment, based on information in my driving record. If such adverse action is taken, I acknowledge that my rights are as follows:

  • Employer must notify me in writing of any such adverse action.
  • I have the right to receive a copy of the driving record upon which the adverse action was based.
  • I have received the Summary Of My Rights Under the Fair Credit Reporting Act. I have the right to know the name, address, and phone number of the consumer reporting agency that provided my driving record to Employer.
  • I have the right to obtain a free copy of my driving record from Employer or Potential Employer, if such a request is made within 60 days from the date that Employer took adverse action.
  • I have the right to dispute the accuracy or completeness of my driving record with the consumer reporting agency that provided it, and request that errors be corrected.

I accept:

Your Full Name: Date of Birth:
Today's Date:
Driver's License Number: State: