"> Career – Fairfax Freight Logistics

Driver Employment Application

Please fill out and submit the application and we will contact you for interview.

Address:

1390 chain bridge road

apt# 3432

McLean VA, 22101

Call Us:

Email Us:

info@FairFaxFreightLogisticsLLC.com

Monday - Saturday:

9:00 – 6:00 pm

Application Form

First Name

Middle Name

Last Name

Current Address

Must list all addresses for previous 3 years

Social Security Number

Date of Birth

Phone Number

Email Address

Emergency Contact Name

Emergency Contact Phone

Driver's License Information

State

Licence #

Type

Expiration Date

Driver Experience

Type of Equipment

From Date

To Date

Approx of Miles

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

Answer

Yes

No

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

Answer

Yes

No

Tickets/Accidents/Etc.

Accident Record for past 3 years

Date

Number of Injuries / Fatalities

Traffic Convictions & Forfeitures for past 3 years

Location

Date

Charge

Penalty

Employment Record

Employer

From - To

Address

Phone

Supervisor

Were you subject to the FMCSRs while employed?

Answer

Yes

No

Was your job designated as safety sensitive function in any DOT regulated mode subject to the drug & alcohol testing requirements of 49 CFR Part 40?

Answer

yes

No

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