Driver Opportunities

Application for Employment

Name:

Email:

Phone:

Date of Birth:

Address:

City:

State:

Zip:

Present or Last Employer

Name:

Address:

City:

State:

Zip:

Number of States:

Position Held:

Dates of Employment:

Second Last Employer

Name:

Address:

City:

State:

Zip:

Number of States:

Position Held:

Dates of Employment:

Third Last Employer

Name:

Address:

City:

State:

Zip:

Number of States:

Position Held:

Dates of Employment:

Current Drivers License

State:

Exp. Date:

License #:

Qualified Experienced Drivers Only
Must have CDL with endorsement.

By checking this box, I hereby certify that all information on this form is correct and complete to the best of my knowledge. I hereby authorize Lotz Trucking, Inc. to do a complete background investigation in accordance with state and federal laws. I authorize my previous employers to release any information requested by Lotz Trucking, Inc. I hereby release all such persons from any liability or damages.