Stidham Trucking, Inc. Driver Recruitment Program Application

Driver Qualification Proposal: Driver License Information

This is the second of 5 pages of the Application Form which you can fill out and submit by e-mail. Please complete and submit Page 1, Personal Information, before you fill out the form below:

Name:
Your email:
Do you currently hold a CDL? Yes: No:
If No, explain.
Is it issued by the state in which you are currently a resident? Yes: No:
If No, please explain.
List the following for the CDL you now currently hold.
State:
License Number:
Expiration date:
Class:
Endorsements:
During the past 5 years have you had any drivers license not listed above?
No: Yes: If Yes, for each list the following:
First additional drivers license
State:
License Number:
Expiration date:
Class:
Endorsements:

Second additional drivers license
State:
License Number:
Expiration date:
Class:
Endorsements:
Has your license, permit or privilege ever been denied, suspended or revoked by any state regardless of your having a license in that state?? No: Yes:
If Yes, explain.
Have you ever been convicted for driving under the influence of alcohol, narcotic drugs, amphetamines, of derivatives thereof during the past 5 years? No: Yes:
If Yes, explain.
During the past 3 years, have you ever been convicted of, or forfeited bond for any traffic violation, other than parking, while operating any type of motor vehicle? No: Yes:
If Yes, for each please complete the following:

First violation
Date:
Violation:
Location:
Type Vehicle:

Second violation
Date:
Violation:
Location:
Type Vehicle:

Third violation
Date:
Violation:
Location:
Type Vehicle:

Fourth violation
Date:
Violation:
Location:
Type Vehicle:

Fifth violation
Date:
Violation:
Location:
Type Vehicle:
 


After submitting Driver License Information above, please continue with page 3 of the Application Form: Driving Experience
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WESTERN DIVISION
P.O. Box 308
Yreka, California 96097
1-800-827-9500
530-842-4161
FAX 530-842-2047






 
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