180 million miles driven per year
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Regional Dedicated (8 regions)
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Recruiting Department
1-800-727-5865
FAX: 1-800-688-1152
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General Information
*
First name:
Middle initial:
*
Last name:
*
Address:
*
City:
*
State:
*
Zip:
How did you hear about Central?
web page
flyer
commercial
driver referral
recruiter
friend
Assignment Desired:
*
SSN/FED ID:
*
Date of Birth:
Gender:
male
female
Spouse's Name:
*
Phone:
Email:
Are you working with a recruiter?
No
Williams, Ryan
Townzen, Roni
Russell, Sarah
Nancollas, Taylor
Maycock, Jyne
Johnson, Rick
Jaco, Amber
Herrera, Mario
Hawkins, Khari
Hadley, Ruston
Ernst, Courtenay
Baldwin, Russell
If you are currently not working for Central,, Or if you are needing an application
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License Information
License Number
*
License State
License Date
License Expiration
Haz-Mat Endorsement?
Yes
No
*
Months of experience
Equipment
Engine size
Licenses held in last 3 years
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Safety Information
*
Number of tickets in the last 3 years:
Explanation:
*
Number of accidents in the last 3 years:
Explanation:
*
Have you
EVER
been convicted or arrested for a felony or misdemeanor?
Yes
No
Explanation:
*
Has your license
EVER
been suspended or revoked?
Yes
No
Explanation:
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Driving School
Experienced drivers do not need to enter driving school info.
Graduate
In School
I Am An Experienced Driver
Driving School Name
School Phone
Graduation Date
City
State
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References
*
Reference 1
Name:
Title:
Phone:
Email:
*
Reference 2
Name:
Title:
Phone:
Email:
*
Reference 3
Name:
Title:
Phone:
Email:
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Work History
*
Current or last Employer:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
*
Employer Name 2:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
*
Employer Name 3:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
Employer Name 4:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
Employer Name 5:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
Employer Name 6:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
Employer Name 7:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
Employer Name 8:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
Employer Name 9:
From Date:
To Date:
Phone:
Job Title:
Address:
City:
State:
Reason for Leaving?
Number of states operated in:
Eligible for rehire?
Yes
No
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Comments
*
I authorize Central Refrigerated Service, Inc. and/or its agents, including consumer reporting bureaus, to verify any of the information I have provided, included but not limited to criminal history, motor vehicle driving records and drug and alcohol history according to the rules fo the FMCSR part 391:
Yes
No
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