Application

Driver Application

Spirit Express, LLC
2024 Polymer Dr
Chattanooga, TN

Welcome!
We are excited that you are considering joining our team.
From proactive safety measures, to our top of the line technology, we are committed to excellence and delivering our products on time, every time.

PERSONAL
First Name*	Middle Initial	Last Name*
Birth Date*(mm/dd/yyyy)	SSN*	Confirm SSN*
Email Address*	Primary Phone*	Secondary Phone

PHYSICAL ADDRESS *Please provide your address for past 3 years (no P.O. boxes)
Address*		City*		State*		Zip*
Address 2		City		State		Zip

EDUCATION
High School
Name of School*	Years*	Diploma or GED?*
College/Trade School
Name of School*	Years*	Degree / Certificate?*
Other
Name of School	Years	Degree / Certificate?

RECORD
Have you ever been convicted of a crime?* Yes No	If yes, please explain
Date of Conviction?
Have you ever been convicted of a DUI?* Yes No	Date of DUI
Do you have a controlled substance conviction?* Yes No	Date of controlled substance conviction?

LICENSE *Section 383.21 FMCSR states "No person who operates a commercial motor vehicle shall at anytime have more than one driver's license." I certify that I do not have more than one motor vehicle license, the information for which is listed below.
Do you have a valid class A Driver's License?* Yes No	Drivers License Number*
Drivers License Expiration*	Issuing State*
Drivers License Endorsements* Hazardous Materials Tank Vehicles

DRIVING RECORD
Have you had any D.O.T. Reportable violations in the past 3 years?* Yes No
If so, how many?
Have you had any citations in the past 3 years?* Yes No
If so, how many?
Have you ever had your license revoked?* Yes No	Date they were revoked?
Have you ever had your license suspended?* Yes No	Date they were suspended?
Have you ever been convicted of reckless driving?* Yes No	Reckless driving date?

D.O.T. REPORTABLE ACCIDENT RECORD (past 3 years)
DATE (month/year)	NATURE OF ACCIDENT (head-on, rear-end, side-swipe, etc)	# OF INJURIES	# OF FATALITIES	SPILL
				Yes No
				Yes No
				Yes No

DRIVING EXPERIENCE
CLASS OF EQUIPMENT	TYPE OF EQUIPMENT (van, tank, flat, etc)	EXPERIENCE
Straight Truck		# of years
Tractor & Semi Trailer		# of years
Tractor & Double Trailer		# of years
Other		# of years

PREVIOUS EMPLOYMENT
All driver applicants to drive in interstate commerce must provide the following information on all employers for the preceding 10 years. List complete mailing address, street number, city, state, and zip code.
1.
Name of Employer*	Name of last supervisor?*
Dates of Employment From: To:
Address*(No P.O Boxes)
City*	State*	Zip*
Telephone Number*	Last Job Title	May we contact this employer?* Yes No
Reason for leaving, be specific	List any skills, duties, advancements, or promotions
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? Yes No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements? Yes No
Any gaps in employment and/or unemployment must be explained. Please include dates (mo/yr) and reason
2.
Name of Employer*	Name of last supervisor?*
Dates of Employment From: To:
Address*(No P.O Boxes)
City*	State*	Zip*
Telephone Number*	Last Job Title
Reason for leaving, be specific	List any skills, duties, advancements, or promotions
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? Yes No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements? Yes No
Any gaps in employment and/or unemployment must be explained. Please include dates (mo/yr) and reason
3.
Name of Employer*	Name of last supervisor?*
Dates of Employment From: To:
Address*(No P.O Boxes)
City*	State*	Zip*
Telephone Number*	Last Job Title
Reason for leaving, be specific	List any skills, duties, advancements, or promotions
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? Yes No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements? Yes No
Any gaps in employment and/or unemployment must be explained. Please include dates (mo/yr) and reason
4.
Name of Employer*	Name of last supervisor?*
Dates of Employment From: To:
Address*(No P.O Boxes)
City*	State*	Zip*
Telephone Number*	Last Job Title
Reason for leaving, be specific	List any skills, duties, advancements, or promotions
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? Yes No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements? Yes No
Any gaps in employment and/or unemployment must be explained. Please include dates (mo/yr) and reason
5.
Name of Employer*	Name of last supervisor?*
Dates of Employment From: To:
Address*(No P.O Boxes)
City*	State*	Zip*
Telephone Number*	Last Job Title
Reason for leaving, be specific	List any skills, duties, advancements, or promotions
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? Yes No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements? Yes No
Any gaps in employment and/or unemployment must be explained. Please include dates (mo/yr) and reason
Use this space for any additional information

REFERENCES
Please list 2 references that are not relatives
Name*	Position*
Company*	Telephone Number*
Name*	Position*
Company*	Telephone Number*
How did you hear about us?:

Certify and Sign
I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize Spirit Express, LLC to make such investigations and inquiries of my personal, employment, criminal histories and other related matters. I have the full understanding that Spirit Express, LLC reserves the right to arrive at a decision based on any information obtained from such inquiries and investigations. I understand that false or misleading information given in my application or interview(s) may result in termination of contract. I understand that I am required to abide by all of the policies and procedures of Spirit Express, LLC and regulations set forth by the Federal Motor Carrier Safety Administration.

Certify and Sign

I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize Spirit Express, LLC to make such investigations and inquiries of my personal, employment, criminal histories and other related matters. I have the full understanding that Spirit Express, LLC reserves the right to arrive at a decision based on any information obtained from such inquiries and investigations. I understand that false or misleading information given in my application or interview(s) may result in termination of contract. I understand that I am required to abide by all of the policies and procedures of Spirit Express, LLC and regulations set forth by the Federal Motor Carrier Safety Administration.

Background Report Disclosure

Please click on the links below to review the release documents:

Link to Previous Employment Release

Link to PSP Release

By checking the box to the left, I acknowledge that I have read each of the above releases and agree that my electronic signature will be applied to each of the documents.*

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

If you accept this Release Statement, please use your mouse to sign in the box below.

Clear

On a phone or tablet use your finger to sign your name in the rectangle above.
On a computer click inside the rectangle and use your cursor to sign your name.
Entire signature must be in box
Retry by hitting the clear button on the top right.