Driver Application | JMF Materials LLC

Full Name *

Date of Birth *

Email Address *

Cell Phone Number *

Job you are applying for *

Select which position you are interested in.

Date available to start *

Please indicate the soonest possible date you could begin working with us.

Social Security Number *

Are you 25 yrs or older *

Yes

No

Are you a US Citizen *

Yes

No

If no, do you have a legal right to live and work in the U.S.?

Yes

No

Motor Vehicle Report *

I understand you will run my MVR

By checking the box, you admit that you understand we will be running your MVR report in order to determine your driving record.

CDL # *

State *

Expiration *

DOT Physical Certificate *

Yes

No

Expiration *

Street Address *

Street

City *

City

State *

State

Zip Code *

Zip

How long? *

Number of years at current residence

Previous Street Address *

Street

Previous City *

City

State *

State

Zip Code *

Zip

How long?

Number of years at previous residence

Emergency Contact *

Phone # *

Relationship to applicant *

Personal Reference #1 *

Phone # *

Relationship to applicant *

Personal Reference #2 *

Phone # *

Relationship to applicant *

Personal Reference #3 *

Phone # *

Relationship to applicant *

Total Truck Driving Experience *

Pneumatic Trailer Experience *

Please list all states you have operated in over past 6 years *

Use abbreviations: e.g. TX, LA, OK, etc.

Types of equipment you have experience with *

Please check all that apply

Please check the box if you CANNOT perform the requested duty

Get in and out of a semi-truck and up and down from a semi-trailer

Get under unit to perform duties, such as checking brakes and visual inspection of equipment

Raise and lower trailer dollies while under a load

Apply enough pressure to release 5th wheel pin

Sit stationary in a driver's seat for long periods of time

Be on duty the maximum hours allowed by D.O.T. Hours of Service Regulations

Please explain any boxes that you checked above

Please list all drivers licenses held in the past three (3) years *

Use this format: State, License #, Class/Endorsements, Expiration;

Have you ever been denied a license permit or privileges to operate a motor vehicle? *

Yes

No

Has any license, permit, or privilege been suspended or revoked? *

Yes

No

Have you ever been convicted of any alcohol related driving offenses? *

Yes

No

Have you ever been convicted for possession, sale, or use of a narcotic drug, amphetamine, or controlled substance? *

Yes

No

Have you ever been convicted of a crime? *

Yes

No

If your answer to the last question was "yes", are you allowed to cross state lines?

Yes

No

Have you ever tested positive or refused to test on a pre-employment drug or alcohol test administered by an employer to which you applied for but did not obtain employment during the past 2 years? *

Yes

No

Have you ever been injured on any job? *

Yes

No

If yes, please explain

Do you have any medical conditions that we need to know about, that would prevent you from performing your duties? *

Yes

No

If yes, what are the condition(s)?

Employment Record: Please start on the first line, with your current or most recent job, and work backwards in order. List your employers, including all full-time and part-time employment, self-employment, military service, and any periods of unemployment. All gaps in employment (military experience, school, etc.) during the past 10 years must be accounted for.

I understand

Current/Most Recent Employer *

Phone # *

Fax #

Date of employment *

From when to when?

Street Address *

Street

City *

City

State *

State

Zip Code *

Zip

Work performed/Equipment used *

Reason for leaving *

Put "N/A" if you still work there

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSR's) while employed by the previous employer? *

Yes

No

Was this job position designated a safety sensitive function in an DOT regulated mode, subject to alcohol and controlled substance testing per 49 CFR Part 40? *

Yes

No

Previous Employer

Put "N/A" if this doesn't apply to you

Phone #

Fax #

Date of employment

From when to when?

Street Address *

Street

City *

City

State *

State

Zip Code *

Zip

Work performed/Equipment used

Reason for leaving

Put "N/A" if you still work there

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSR's) while employed by the previous employer?

Yes

No

Was this job position designated a safety sensitive function in an DOT regulated mode, subject to alcohol and controlled substance testing per 49 CFR Part 40?

Yes

No

Previous Employer

Phone #

Fax #

Date of employment

From when to when?

Street Address *

Street

City *

City

State *

State

Zip Code *

Zip

Work performed/Equipment used

Reason for leaving

Put "N/A" if you still work there

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSR's) while employed by the previous employer?

Yes

No

Was this job position designated a safety sensitive function in an DOT regulated mode, subject to alcohol and controlled substance testing per 49 CFR Part 40?

Yes

No

Previous Employer

Phone #

Fax #

Date of employment

From when to when?

Street Address *

Street

City *

City

State *

State

Zip Code *

Zip

Work performed/Equipment used

Reason for leaving

Put "N/A" if you still work there

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSR's) while employed by the previous employer?

Yes

No

Was this job position designated a safety sensitive function in an DOT regulated mode, subject to alcohol and controlled substance testing per 49 CFR Part 40?

Yes

No

Previous Employer

Phone #

Fax #

Date of employment

From when to when?

Street Address *

Street

City *

City

State *

State

Zip Code *

Zip

Work performed/Equipment used

Reason for leaving

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSR's) while employed by the previous employer? *

Yes

No

Was this job position designated a safety sensitive function in an DOT regulated mode, subject to alcohol and controlled substance testing per 49 CFR Part 40? *

Yes

No

I am applying for a position with JMF Materials, LLC (referred to in this application as "JMF"), and I understand the following: Any falsification of information provided to JMF or failure to pass the DOT Pre-employment drug test makes me ineligible for employment with JMF. DUI or DWI within the last 5 years, at-fault accident, or more than 2 moving violations within the last 3 years, or any violation not acceptable to JMF's current insurance provider, could make me ineligible for employment with JMF. If I am hired by JMF and voluntarily leave prior to 90 days satisfactory completion of employment, JMF may withhold the cost of (but not limited to): pre-employment drug screen, expenses related to training or other costs related to my hiring, vehicle interior cleaning (up to $100), repairs due to unauthorized changes to a vehicle in my care, damage to equipment or replacement of items provided by JMF. I understand that I must provide my own equipment or replacement of items provided by JMF. I understand that I must provide my own equipment required for the job as per industry standards. I hereby authorize JMF to run my State Driving Record (M.V.R.). I hereby authorize JMF to check my employment history and references. *

I understand and accept these terms

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24 Years of Service 150 Wells Completed - 13 Fleet Size

24 Years of Service
150 Wells Completed - 13 Fleet Size