APPLICATION

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First Name *

Middle Name *

Last Name *

Email Address *

Address *

Address Line 2

City *

State *

ZIP Code *

Phone Number *

Alternate Phone Number *

Date of Birth *

Social Security Number *

Position Applying For *

Company Driver

Owner Operator

Division Applying For *

Hopper Division

Van Division

Both Divisions

ADDRESS HISTORY

Please list address history for the previous 5 years, not including your current address.

ADDRESS 1

Address

Address Line 2

City

State

ZIP Code

ADDRESS 2

Address

Address Line 2

City

State

ZIP Code

ADDRESS 3

Address

Address Line 2

City

State

ZIP Code

DISCLOSURES

Have you ever been convicted of a misdemeanor? *

Yes

Have you ever been convicted of a felony? *

Yes

Are you 18 or older? *

Yes

Are you authorized to work in the United States? *

Yes

Do you have a valid class A CDL? *

Yes

The company performs background checks on all applicants who receive a job offer. Will you authorize the company to conduct a background investigation, including a criminal background check? *

Yes

Do you have a valid D.O.T. Physical? *

Yes

Do you have any endorsements on your CDL? *

Yes

Do you have a Twic Card? *

Yes

Have you been employed by H&M Trucking before? *

Yes

Are you aware of the essential functions and job duties of the position(s) for which you are applying? *

Yes

Are you physically and mentally able to perform the essential functions and job duties of the position(s) for which you are applying, with or without accommodation? *

Yes

Have you been in any accidents over the past 5 years? *

Yes

Have you received any traffic tickets or convictions in the last 6 years? *

Yes

CDL EXPERIENCE

Do you have any experience driving a Straight Truck? *

Yes

Do you have any experience driving a Tractor and Semi-Trailer? *

Yes

Do you have any experience driving a Tractor with Two-Trailers (Doubles)? *

Yes

Do you have any experience driving a Tractor with Three-Trailers (Triples)? *

Yes

Please list any and all states in which you have operated in for the past five years: *

What type of transmission do you drive? *

Auto

Manual

Other

What types of transmissions have you used?

List any Military Service including the branch and dates:

Have you attended any formal training for CDL driving, ie Truck Driving School?

Yes

List any Safe Driving Awards you hold & from whom:

Have you ever been denied a license, permit or privilege to perate a motor vehicle? *

Yes

Please list any previous license's held for the past five years:

EDUCATION

Please select the highest grade completed in High School: *

8th 9th 10th 11th 12th

Please select the highest year of college completed: *

None 1st Year 2nd Year 3rd Year 4th+ Year

EMPLOYMENT HISTORY

Please fill out the last 10 years of your job history.
Also list any periods of unemployment as well.

EMPLOYER 1

Company Name *

Company Phone *

Start Date *

End Date *

Position Held *

Company Address *

Company Address Line 2

City *

State *

ZIP Code *

Reason for Leaving *

Duties *

Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Yes

Were you subject to the FMCSR's* while employed here? *

Yes

What type of driving did you do while employed at this company? Over the Road, Regional, Local or non-driving? *

Over The Road

Regional

Local

Non-Driving

EMPLOYER 2

Company Name

Company Phone

Start Date

End Date

Position Held

Company Address

Company Address Line 2

City

State

ZIP Code

Reason for Leaving

Duties

Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Yes

Were you subject to the FMCSR's* while employed here?

Yes

What type of driving did you do while employed at this company? Over the Road, Regional, Local or non-driving?

Over The Road

Regional

Local

Non-Driving

EMPLOYER 3

Company Name

Company Phone

Start Date

End Date

Position Held

Company Address

Company Address Line 2

City

State

ZIP Code

Reason for Leaving

Duties

Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Yes

Were you subject to the FMCSR's* while employed here?

Yes

What type of driving did you do while employed at this company? Over the Road, Regional, Local or non-driving?

Over The Road

Regional

Local

Non-Driving

Add another employer?

Yes No

REFERRAL, RESUME AND ADDITIONAL INFORMATION

How did you hear about this position?

Randy Mueller

Michaela Ginn

Rachel Powles

Facebook

Website

Other

Upload Résumé (optional)

Please upload your résumé in PDF format.

*The Federal Motor Carrier Safety Regulations (FMCSR's) apply to anyone who operates a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) has a GVWR or weighs 10,001 pounds or more, (2) is designated or used to transport nine or more passengers, or (3) is of any size, used to transport hazardous materials in a quantity requiring placarding.

Additional Information/Job Descriptions

Please provide any additional comments or information you would like to share.

At H & M Trucking, Inc. we believe our success directly correlates to the success of our drivers. By building strong relationships through honesty and respect, we maintain a low turnover rate and enjoy a team-oriented atmosphere. Our high safety standards and use of the latest technology and equipment guarantees our drivers are protected and prepared as they travel across the country.

For any questions or more information, please contact:

Eve Essary

Human Resources & Recruiting Manager
Eve.Essary@hmtrucking.com
EXT: 3457