Owner Operator/CDL Driver Application

Merida Exp LLC Truck Driver and CDL Driver Application Form

Application Type*

Full Name*

Complete Address*

Email Address*

Phone Number*

Mobile Phone Number*

Pager*

Best/Quickest Method of Contact*

Date of Birth*

SSN*

Need Training?*

Student or Recent Grad?*

If Yes, Provide the Name of Your School and the Location*

Do you have a CDL?*

If Yes, Provide the State, Class, Number and Expiration Date*

Can You Begin Work Immediately?*

If No, When Are You Available?*

Do You Have a HazMat Endorsement?*

Other Endorsements?*

Years of Truck Driving Experience*

Have You Ever Had a DUI?*

If Yes, When?

Have You Ever Had a Felony?*

If Yes, When?

Describe the Felony*

Has Your License Ever Been Suspended?*

Number of Moving Violations in Last Year?*

Number of Moving Violations in Last 3 Years?*

Number of Accidents in Last Year?*

Number of Accidents in Last 3 Years?*

Present Employer Name*

May We Contact Them?*

Date of Employment* (From)

Date of Employment* (To)

Telephone*

Complete Address*

Type of Trailer*

Number of States*

Reason for Leaving/Comments*

First Previous Employer Name*

May We Contact Them?*

Date of Employment* (From)

Date of Employment* (To)

Telephone*

Complete Address*

Type of Trailer*

Number of States*

Reason for Leaving/Comments*

Second Previous Employer Name*

May We Contact Them?*

Date of Employment* (From)

Date of Employment* (To)

Telephone*

Complete Address*

Type of Trailer*

Number of States*

Reason for Leaving/Comments*

Third Previous Employer Name*

May We Contact Them?*

Date of Employment* (From)

Date of Employment* (To)

Telephone*

Complete Address*

Type of Trailer*

Number of States*

Reason for Leaving/Comments*

Trailer Experience and/or Endorsements*

Are You Interested in Driving Regional?*

Do You Currently Lease or Own a Tractor?*

If Yes, Provide the Year, Make, Type, Engine Size, Mileage, Tractor Weight, Wheelbase, and 5th Wheel Height*

If No, Are You Interested in a Lease Purchase Program?*

Do You Own Your Own Trailer?*

If Yes, Provide the Type*

Free Text

The DOT requires a carrier to investigate your employment background when considering your application. This may include obtaining a consumer report from DAC Services. If you are not hired by a company based on information contained in your consumer report, you will be advised. You will also be advised of your right to obtain a free copy of the consumer report from DAC and your right to dispute the information in your report. Your consent is necessary for a company to obtain a report from DAC.

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I have read this release and do not grant permission for company(s) to request a consumer report on me from DAC.