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Driver Minimum Qualification Sheet

Thank you for your interest in Global Logistics Trucking. Below is a quick survey to see if you meet
Our minimum qualifications. Please answer all of the questions to see if you qualify.
Once again. Thank you for your interest.

Applicants Name:
Please mark the answer that applies for each question:
1. Are you 18 years of age or older?
No - You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - please continue to # 2
2, Is your MVR accident/DWI free for the last 3 years?
No- You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please Continue to # 3
3. Do you understand that you are applying for an "At-Will" ?
No- You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please Continue to # 4
4. Do you understand that you are applying for an "Independent contractor position-1099" position and that the
company is not offering employment for any length of time?
No- You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please Continue to # 5
5. Do you understand that Global Logistics Trucking, Inc. is an Equal Employment Opportunity
Employer?
No- You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please Continue to # 6
6. Do you have 5 OR LESS tickets on your MVR?
No -You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please continue to # 7
7. Do you have at least 3 years of verifiable driving Experience?
No -You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please continue to # 8
8. Have you hauled pipe before?
No -You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please continue to # 9
How much experience do you have hauling pipe.
0-3 Months
3 Months 6 Months
6 Months 1 Year
1 Year or more
9. Have you hauled steel coils before?
No -You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please continue to # 10
How much experience do you have hauling steel coils?
0-3 Months
3 Months 6 Months
6 Months 1 Year
1 Year or more
10. Do you have tarping experience?
No -You do not qualify to drive for Global Logistics Trucking, Inc.
Yes - Please continue to # 10

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11. What Region are you interested in?

Local
Regional
OTR

If you have answered all the questions and instructed to read below; then you are qualified to apply
with Global
Logistics-Trucking. Please continue on with the application. Please remember to return both your questionnaire and
application form.

DRIVER'S APPLICATION FOR EMPLOYMENT

Global Logistics - Trucking is an Equal Opportunity Employer and is committed to complying with State and
Federal equal opportunity law. Qualified applicants are considered for all positions without regard to race, color, religion,
sex, national origin, age or disability.
Date of Application_Click here to enter a date.

Name.____________________________________________ Social Security No.___________________

Last
First
Middle

Drivers License Number:___________________________________________

Date of Birth ______________________________ Can you provide proof of age?_____________________________________
(MUST BE AT LEAST 18 years OF AGE)

Home Phone: __________________________Cell Phone: _____________________________________

Emergency Number: ____________________Emergency Contact Person: ________________________

Email Address:______________________________________________

Position (s) Applied for:

Flatbed
Van

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Heavy Haul
All of the Above

How did you hear about us?

Facebook
Craigslist
Referral
Texas Workforce Commission
Driver ______________________
Other

List your addresses of residency for the past 5 years.

Current Address:
Click here to enter text.Click here to enter text. Click here to enter text. How Long?_______
Current Address: Street
City/State
Zip

Previous Address:
Click here to enter text.Click here to enter text. Click here to enter text. How Long?_______
Current Address: Street
City/State
Zip

Do you have the legal right to work In the United States? ________________________________________________

Do you have the transportation to from work?( a vehicle to leave at the yard) _________________________________

Yes
NO

Are you now employed? If not, how long has it been since you left your last employment?

Yes
NO

Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in
the attached job description)?__________________________________________________________________________
If yes, explain, __________________________________________________________________________________

EDUCATION

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CIRCLE HIGHEST GRADE COMPLETED: 1 2 3 4 5 6 7

0-3 Months
3 Months 6 Months
6 Months 1 Year
1 Year or more
HIGH SCHOOL: 1 2 3 4

COLLEGE: 1 2 3 4

0-3 Months
3 Months 6 Months
6 Months 1 Year
1 Year or more

LAST SCHOOL ATTENDED Click here to enter text.Click here to enter text.
(NAME)
(CITY)

ARE YOU FAMILIAR WITH HOW TO COMPLETE AN ACCIDENT REPORT FORM AND THE PROCEDURES TO TAKE IF AN ACCIDENT
OCCURS?

ACCIDENT RECORD FOR THE PAST 5 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS
NEEDED)
DATES

NATURE OF ACCIDENT

FATALITIES

INJURIES

TRAFFIC CONVICTIONS/ TICKETS AND FOREFEITURES FOR THE PAST 5 YEARS (OR OTHER
PARKING VIOLATIONS) (IF NONE, WRITE NONE)
LOCATION

DATE

CHARGE

PENALTY

OPEN TICKETS/WARRANTS:

YES
NO
LICENSENSE RESTRICTIONS:

YES
NO
Have you ever been convicted of a CRIME in the last 10 years(MISDEMEANOR OR FELONY). YES or NO
.Explain on separate paper.
LOCATION

DATE

CHARGE

PENALTY

CRIMINAL CONVICTIONS/ TICKETS AND FOREFEITURES FOR THE PAST 5 YEARS (Have you ever been
convicted of any criminal activity involving CMV or while in CMV. YES or NO .Explain on separate paper.
LOCATION

OPEN
TICKETS/WARRANTS:

DATE

CHARGE

PENALTY

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A.

Do you have a current Drivers Licenses issued by more than one state?
a.
YES_____ NO ________
(Please include DL #Click here to enter text.
(Any restrictions?)____________________________________)
b.
YES____ _NO ________

B.

B. Have you ever been denied a license, permit or privilege to operate a motor vehicle?

YES____

_NO _______

If yes, please explain the circumstances on a separate piece of paper.

________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________

C.

Has any license, permit or privilege ever been suspended or revoked

a.
YES____ NO ________

If the answer to either B or C is yes, attach statement giving details.

DRIVING EXPERIENCE IF NONE, WRITE NONE

CLASS IF

TYPE

DATE

DATE

APPROX NO OF MILES

STRAIGHT TRUCK
TRACTOR(FLATBED)
TRACTOR-VAN OR REEFER
TRACTOR-DROP DECK

List the states operated for the last five years.

Which safe Driving Awards do you hold?______________________________________________

Houston, Texas
Voice: 281-631-0763/832-692-1643
Fax: 281-440-9738
arteka@sbcglobal.net
sammylouis@sbcglobal.net

Name:Choose an item.

SS# _____________ DOB __/__/__

Have you had a positive drug test in the last 2 yrs.?

YES____

_NO _______

when?_________________________
Please Explain: ________________________________________________________________
Have you ever filed unemployment?
YES____

_NO _______

when?_________________________
Please Explain:__________________________________________________________________
Have you ever been injured on the job?
YES____

_NO _______

when?_________________________

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Please Explain: __________________________________________________________________

Have you ever filed Workers Compensation?(please complete attached form)
YES____

_NO _______

when?_________________________
Please Explain:__________________________________________________________________
All driver applicants to drive in interstate commerce must provide the following information on all employers
During the past 5 yearsIf you were unemployed for a period of one month or longer, please state your activities
during that time
At least 3 years driving experience with at least 3 year flat bed, please include phone number to contact previous
employer to verify employment Start and end date of your most recent employer.

PLEASE LIST ALL FLATBED RELATED EMPLOYERS BELOW (last 7 years)

CURRENT OR LAST EMPLOYER

Phone

REASON FOR LEAVING

ADDRESS

Fax

EQUIP

NOTES

CURRENT OR LAST EMPLOYER

Phone

REASON FOR LEAVING

START DATE /END DATE

ADDRESS

Fax

EQUIP

NOTES

CURRENT OR LAST EMPLOYER

Phone

REASON FOR LEAVING

START DATE /END DATE

ADDRESS

Fax

EQUIP

NOTES

CURRENT OR LAST EMPLOYER

Phone

REASON FOR LEAVING

START DATE /END DATE

ADDRESS

Fax

EQUIP

NOTES

Phone

REASON FOR LEAVING

START DATE /END DATE

Subject to FMCSR

Subject to FMCSR

Subject to FMCSR

Subject to FMCSR

START DATE /END DATE

yes or no

yes or no

yes or no

yes or no

CURRENT OR LAST EMPLOYER

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Fax

ADDRESS

Subject to FMCSR

EQUIP

NOTES

yes or no

YOUR UNDERSTANDING AND AGREEMENT TO THE TERMS OF THIS APPLICATION

1 I, (referred to also as the contractor) understand that I may be denied or removed after accepting the above contract position if the information I
provide in this application is not completely truthful. The information I provide in this application is completely truthful to the best of my knowledge
and belief.
2 I authorize Global Logistics - Trucking to verify all of the information I provide in this application and Understand that Global Logistics Trucking, Inc. may contact anyone with knowledge about me. I agree not to sue or hold liable any persons who respond to Global
Logistics - Trucking questions about me.
3 I understand that I am applying for a position that is At-Will and that if I am hired: Global Logistics - Trucking makes no guarantees about the
length of my contract if hired.. I understand that Global Logistics - Trucking can terminate my contract at any time and that in return, and I agree to
provide Global Logistics - Trucking a one week notice.

Please circle those that apply:

Please include a copy of all items listed below:
SSN card:
DOT card:
Driver's License:
DAC- Phone: 1800-381-0645 Fax: 1-918-664-5520
http://www.hireright.com/Consumers-Applicants.aspx--- please use arteka@sbcglobal.net as the email address.
MVR: http://www.texasonline.gov
Other:
TWIC:
HAZMAT:
TANKERS:
DOUBLE/TRIPLES:

APPLICANT'S SIGNATURE INDICATES ACCEPTANCE OF THE TERMS ABOVE

__Choose an item.___________________________________ ______________

Printed Name

Signature

Click here to enter a date.

Date

DRIVER BACKGROUND INVESTIGATION RELEASE

In connection with your application for employment with Global Logistics Trucking, it may
obtain one or more reports regarding your credit, driving, and/or criminal background history
from a consumer reporting agency and/or other sources.
I authorize Global Logistics Trucking, to contact any organization or individual that I have
listed on my employment application or resume or mention in job interviews and obtain from
them any relevant information about my job qualification, including my experience skills, and
abilities. I understand that I am consenting to the release of safety performance information
including crash data from the previous five years and inspection history from the previous five

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years, as well as any reference-related information about me held or known by my former

employers, supervisors, and co-workers. In addition I consent to release of any information
about my education, experience, abilities, or work-related characteristics or traits held or known
by other organizations or individuals, including school and educational institutions, professional
or business associates, and friends and acquaintances that might be contacted in the course of
conducting a reference check or background investigation of my suitability for employment.
I understand and acknowledge that is release of information can involve my qualifications,
performance, credentials or other characteristics or factors affecting my suitability for
employment with employer. Specifically, I am authorizing the release of any information
about my performance, experience capability, attitude, specific events, or other work-related
characteristics that currently are in the possession of the requested organization or their
managers or representatives.
I agree not to file or pursue any complaints, claims, or legal actions of any kind against any
organization or individual that provides work related information about me to Global Logistics
Trucking or its agents in accordance with the terms and intent of this release. I also agree not to
file or pursue any complaints, claims, or legal actions against Global Logistics Trucking or any
of its employees, representatives, or agents arising out of their efforts to obtain work related
information about me.
I understand that signing this consent form gives Global Logistics Trucking, Inc. and/or any
other entity it retains; permission to obtain background reports and may obtain reports of my
credit, driving, and criminal background history in addition to information regarding my
background, references, education, specific events, and past employment.
I hereby authorize Global Logistics Trucking and its employees, agents, and its affiliates to
obtain the information authorized above.
Print Name:

Signature:

Date:

Choose an item.

CERTIFICATION COMPLIANCE WITH DRIVER LICENSE REQUIREMENT

MOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to every driver who operates in intrastate, interstate
or foreign commerce and operates a vehicle weighing 26,001 pounds or more, can transport more than 15 people, transports
hazardous materials that require placarding.
The requirements in part 391 apply to every driver who operates in interstate commerce and operates a vehicle weighing
26 ,001 pounds or more, can transport more than 15 people, transports hazardous materials that require placarding.
DRIVER REQUIREMENTS: Parts 3836 and 391 of the Federal Motor Carrier Safety Regulations contain some requirements
that you as a driver must comply with. These requirements re in effect as of July 1, 1987. They are as follows:
1.

You as a commercial driver, may not possess more than one license.

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2.
3.

If you currently have more than one license you should keep the license from your state of residence, and return
the additional license to the state that issued them. Destroying a license does not close the record in the state that
issued it, you must notify the state.
Sections 392.42. and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your
employer the NEXT BUSINESS DAY of any revocation or suspension of your drivers license. In addition, Section
383.3 requires that any time you violate a state or local traffic law(other than parking), you must report it to your
employing motor carrier and the state that issued your license within 30 days.

DRIVER CERTICATION: I certify that I have read and understand the above requirements.
The following license is the only one I possess:

Print Name:Click here to enter text.

Date:

Signature:

Driver License Number: Choose an item. State: Choose an item.Expiration:Click here to enter a date.
LICENSE RESTRICTIONS:

Choose an item.

ALCOHOL AND CONTROLLED SUBSTANCE CONSENT AND RELEASE

Have you ever tested positive, adulterated, or substituted test specimen?

YES or NO

Have you ever refused drug/alcohol test of any kind?(pre-employment, post-accident, random)?

YES or NO

Have you had an alcohol test with a result of .04 or higher?

If you answered yes to any of the following please attach a statement of explanation.

YES or NO

I understand, that as required by the Federal Motor Carrier Safety Regulations or company policy, all drivers must submit to
alcohol and controlled substance testing as a condition of employment. I also understand that any offer of employment will be
contingent upon the results of an alcohol and controlled substance test.

P a g e | 10
Therefore, I agree to submit to the following alcohol and controlled substance tests in accordance and as defined by the
Federal Motor Carrier Safety Regulation and this companys policies:

Pre-Employment, to determine employment eligibility

Random
Reasonable suspicion
Post-Accident
Follow up
Return to duty

I certify that I have read and understand, and agree to abide by the condition of this consent and release form. Failure to sign
will prevent this employer from using you as a CMV driver.

Signature/Date:
Print Name:

Click here to enter text.

SSN:

Choose an item.