APPLY | D+S Distribution

EMPLOYMENT

With local dedicated routes, our drivers are able to provide consistent quality results,

D + S Distribution Services, Inc. is able to provide expedited, personalized services.
With local dedicated routes, our drivers are able to provide consistent quality results, while also being able to spend each night at home. By focusing on a niche area we are able to live up to our promises to ensure that your shipment — whether big or small — will get to its destination on time.

APPLICANT INFORMATION

Date of Application(Required)

Position Desired(Required)

Last Name(Required)

First & Middle Name(Required)

Date of Birth(Required)

Social Security Number

Phone Number(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Have you applied for work and/or worked for this company before?(Required)

If hired, can you provide evidence of U.S. Citizenship or proof of your legal right to live and work in this country?(Required)

How did you find out about D+S Distribution Services?(Required)

MILITARY STATUS

Last School Attended(Required)

Highest Level of Education(Required)

List other specialty training or schools

Have you ever received any safety awards?

Do you have full knowledge of the Federal Motor Carrier Safety Regulations?

Have you ever been convicted of a crime, other than minor traffic violations?

Have you been discharged or asked to resign by any other employer?

EDUCATIONAL & PERSONAL INFORMATION

Have you served in the U.S. Armed Forces?

EMPLOYMENT RECORD FOR PAST FIVE YEARS

All applicants must list all full and part-time employment including military service, self-employment and periods of unemployment during the preceding ten years. Note: List employers in reverse order starting with the most recent.

CURRENT OR MOST RECENT EMPLOYER

Name(Required)

Supervisor(Required)

Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Position Held(Required)

Equipment Type(Required)

Date of Employment - From(Required)

To(Required)

Reason for Leaving(Required)

Gap in Employment - From(Required)

To(Required)

Explain

Was this job designated as a safety sensitive function in any DOT regulated mode subject to controlled substances and alcohol testing specified by 49 CFR Part 40?(Required)

*Was this job subject to FMCSA Regulations?(Required)

*The Federal Motor Carrier Safety Regulations apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle 1) weighs or has a GVWR of 10,001 pounds or more, 2) is designed or used to transport 9 or more passengers, or 3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

COMMERCIAL DRIVER'S LICENSE INFORMATION

DRIVING EXPERIENCE

Class of Equipment(Required)

Type of Equipment(Required)

Van, Tanker, Flat, etc.

Date - From(Required)

Date - To(Required)

Approximate Miles(Required)

Class of Equipment

Type of Equipment

Van, Tanker, Flat, etc.

Date - From

Date - To

Approximate Miles

Class of Equipment

Type of Equipment

Van, Tanker, Flat, etc.

Date - From

Date - To

Approximate Miles

Class of Equipment

Type of Equipment

Van, Tanker, Flat, etc.

Date - From

Date - To

Approximate Miles

ALL DRIVER'S LICENSES HELD IN THE PAST THREE YEARS

License Number(Required)

Type(Required)

State/Province(Required)

Expiration Date(Required)

License Number

Type

State/Province

Expiration Date

License Number

Type

State/Province

Expiriation Date

Endorsements (Check all that apply):

Double/Triple Trailers

Passenger Vehicles

Tank Vehicles

Hazardous Materials

Have you ever been denied a license or privilege to operate a motor vehicle?(Required)

Has any license, permit, CDL, or privilege to operate a motor vehicle ever been denied, suspended or revoked?(Required)

ACCIDENTS(Required)

Please list all motor vehicle collisions in which you were involved (both commercial and private vehicle) during the past three years prior to the application date. Please include the date, state/province, number of injuries, number of fatalities, and if there was a HAZMAT spill. If no accidents occurred, write "none" in the description box.

TRAFFIC ACCIDENTS & FORFEITURES(Required)

Please list all traffic convictions and/or forteitures (both commercial and private vehicle) during the past three years (other than parking). Please include the date, location, charge, and penalty. If none, write "none".

Have you ever tested positive, or refused to test on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety sensitive transportation work covered by DOT agency drug and alcohol testing during the past two years?(Required)

Full Name(Required)

Date(Required)