DRIVER APPLICATION Job Application Job Application First Name * Middle Name * Last Name * Date of Birth * Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Phone * Email Address * Do you have a CDL? * Yes No Issue State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Check all that apply to your current CDL / CHAUFFEUR LICENSE : Class A Class B Tanker Passenger Air Brake Hazmat Date Available To Start * Do You have Drive Away Experience? * Yes No Do You have a tow vehicle? * Yes No Are you currently employed? * Yes No Current Employer Current Employer Phone Number Current Employer City Hired Date May We Contact This Employer? Yes No Previous Employer Previous Employer Phone Number Previous Employer City Hired Date End Date Reason For Leaving? May We Contact This Employer? Yes No DRIVING HISTORY (driving awards, states driven, etc.) Number of preventable accidents? * Number of tickets received? * Have you been convicted of a felony? (In the last 10 years) * Yes No In the last 7 years, have you ever been convicted, or are any charges pending, for driving while under the influence of alcohol, a narcotic drug, amphetamines or derivatives thereof? * Yes No Have you ever been convicted of a misdemeanor or have any charges pending? * Yes No 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 Have you ever tested positive or refused a test for drugs or alcohol? * Yes No ** If you answered yes to any of the above, please explain in the comments box below. How did you hear about AAA? I have read and agree to the above release and I give permission to obtain consumer reports about me * Yes No Paragraph Text * I HEREBY AUTHORIZE, WITHOUT LIMITATION OR RESERVATION, all persons and entities receiving this Authorization including, but not limited to, corporations, companies, educational institutions, persons, law enforcement agencies, military services, credit agencies, and former employers/contractors, to release information which they may have about me to AAA Interstate Transportation LLC and their agents, and I release them from any liability or responsibility for doing so. I HEREBY FURTHER AUTHORIZE the procurement of my Motor Vehicle Record from my and all appropriate agencies and an investigative consumer report. I understand that such a report may contain information about my background, character, and personal reputation and that further information may be available upon written request within a reasonable period of time. A photocopy of this release shall be as valid as the original. This authorization shall be valid for one year from the date of signing hereof. If contracted, this authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer reports at any time during my term as a self employed contract driver with AAA Interstate Transportation LLC. If you are human, leave this field blank.