APPLICATION FOR EMPLOYMENT
(PRE-EMPLOYMENT QUESTIONNAIRE) (AN EQUAL OPPORTUNITY EMPLOYMENT)

Select a company:
FREIGHT AGENCY, INC.      DIVERSIFIED TRANSFER & STORAGE, INC.
DTS LOGISTICS                    DIVERSIFIED TRUCK LEASING


Specific Position Applied for:     Today's Date: 

APPLICANTS: IN ORDER TO BE CONSIDERED FOR EMPLOYMENT, THIS APPLICATION MUST BE COMPLETED ENTIRELY. PLEASE REMEMBER TO PRINT CLEARLY, AND TO READ AND SIGN THE LAST PAGE.

Full Name Home Phone
Address City State Zip
Daytime or Message Phone Social Security Number Drivers Licence Number State of Issue
Are you employed now? Can we contact your current employer? Date you can start Salary Desired
Yes     No Yes     No
Email Address


EDUCATION

Select highest grade completed in school: Grade / High School | College | Graduate
 
  1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 1 2 3 4

  Name of school Location Diploma or Degree Major
High School
College or University
Graduate School
Vocational or Training

ADDITIONAL INFORMATION  
Professional Memberships and Affiliations 
Professional and Trade Licenses
Special Study or Research Work


EMPLOYMENT HISTORY
This section must be completed entirely. Do not substitute a resume. List all work experience, paid or unpaid, beginning with your current or most recent job. Include military experience as well as volunteer jobs that you wish to have considered as part of your qualifications for the position you are seeking.

Describe each job separately, emphasizing your specific tasks and any supervisory, technical or other responsibilities. Explain all breaks in continuous employment. If more space is needed, additional pages can be added.

PRESENT OR LAST POSITION (1)


Employer:
Start Date:
(month) (year)         
End Date:
Address:
Supervisor's name: Supervisor's telephone:
Your Title: Full-Time: Part-Time: Hours worked per week: Paid: Unpaid: Salary:
Duties / responsibilities (be specific)
Reason for leaving or considering a change

Additional History (2)
Employer:
Start Date:
(month) (year)         
End Date:
Address:
Supervisor's name: Supervisor's telephone:
Your Title: Full-Time: Part-Time: Hours worked per week: Paid: Unpaid: Salary:
Duties / responsibilities (be specific)
Reason for leaving or considering a change

Additional History (3)
 
Employer:
Start Date:
(month) (year)         
End Date:
Address:
Supervisor's name: Supervisor's telephone:
Your Title: Full-Time: Part-Time: Hours worked per week: Paid: Unpaid: Salary:
Duties / responsibilities (be specific)
Reason for leaving or considering a change

Additional History (4)
 
Employer:
Start Date:
(month) (year)         
End Date:
Address:
Supervisor's name: Supervisor's telephone:
Your Title: Full-Time: Part-Time: Hours worked per week: Paid: Unpaid: Salary:
Duties / responsibilities (be specific)
Reason for leaving or considering a change


PHYSICAL RECORD
Do you have any physical limitations that preclude you from performing any work for which you are being considered? Yes No.
If yes, please describe:
 
  Name Address Phone
In case of emergency Notify:

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SUBMITTING THE APPLICATION:
FREIGHT AGENCY, INC./ DIVERSIFIED TRANSFER & STORAGE, INC./ DTS LOGISTICS/ DIVERSIFIED TRUCK LEASING are an equal opportunity employer and does not discriminate on the basis of sex, age, race and color, religion, marital status, national origin, disability or veteran status.

Interviews are given on a competitive basis, using job-rated factors, after a written application has been received and reviewed. Because of the large number of applications received, not everyone who applies for a vacant position will be interviewed.

I certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I understand that any misrepresentation or material omission to this application will result in my being eliminated from further consideration. I further understand that, if accepted for employment, any misrepresentation or material omission which becomes known to FREIGHT AGENCY, INC./ DIVERSIFIED TRANSFER & STORAGE, INC./ DTS LOGISTICS/ DIVERSIFIED TRUCK LEASING, may result in the termination of my employment.

I authorize all previous employers and supervisors, including all persons with and whom I have worked, to give FREIGHT AGENCY, INC./ DIVERSIFIED TRANSFER & STORAGE, INC./ DTS LOGISTICS/ DIVERSIFIED TRUCK LEASING's representatives any and all information regarding me and my previous employment. I release FREIGHT AGENCY, INC./ DIVERSIFIED TRANSFER & STORAGE, INC./ DTS LOGISTICS/ DIVERSIFIED TRUCK LEASING ,and all previous employers and supervisors from any liability for any damages that may result from furnishing information to FREIGHT AGENCY, INC./ DIVERSIFIED TRANSFER & STORAGE, INC./ DTS LOGISTICS/ DIVERSIFIED TRUCK LEASING.

It is agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an Investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, motor vehicle record, credit status and mode of living. If hired or contracted, this authorization shall remain on file and shall serve as ongoing authorization for DTS to procure consumer reports at any time during my employment or contract period.

I understand that, if selected, I will require to provide proof of my identity and legal right to work in the United States prior to actual employment with FREIGHT AGENCY, INC./ DIVERSIFIED TRANSFER & STORAGE, INC./ DTS LOGISTICS/ DIVERSIFIED TRUCK LEASING. I also agree to submit to any pre-employment physical and drug screening the companies require for all safety sensitive positions.

I have read the above statement and I agree.
  I disagree. Signature Date