CDL Application


CDL Application

What is your contact info?

Full Time
Part Time
Seasonal / Internship
Days
Evenings
Weekends
Yes
No
Yes
No
Yes
No
Yes
No

EDUCATION

School #1

Yes
No

School #2

Yes
No

School #3

Yes
No
Yes
No

Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap or veteran status.

EMPLOYMENT HISTORY

Past Employer #1

Yes
No

Past Employer #2

Yes
No

Past Employer #3

Yes
No

License Information

Section 383.21 FMCSR states “No person who operates a commercial motor vehicle shall at any time have more than one driver’s license.” I certify that I do not have more than one motor vehicle license, the information for which is listed below.

Yes
No
Yes
No

Experience and Qualifications - Other

Gold-Eagle Cooperative/CORN, LP

Applicant Notification and Release

As part of our hiring background and investigation, we may obtain consumer reports to prepare an investigative consumer report. The investigative consumer report may consist of contacting all listed prior employers to verify your employment history. It may also include, but not be limited to, credit information reports, criminal history reports and driving history records. Under the provisions of the Fair Credit Reporting Act (15 USC at 1681-1681u) as amended, before we can seek such reports, we must have your written permission to obtain the information. You have the right, upon written request, to a complete and accurate disclosure of the nature and scope of the investigation. You are also entitled to a copy of your Rights Under the Fair Credit Reporting Act.

Under the provisions of the Fair Credit Reporting Act, 15 USC, Section 1681 et seq., the Americans with Disabilities Act and all applicable federal, state, and local laws, I hereby authorize and permit Gold-Eagle Cooperative / CORN, LP to obtain a consumer report and/or an investigative consumer report which may include the following:

My employment records; Records concerning any driving, criminal history, credit history, civil record, workers’ compensation (post-offer only) and drug testing; (For truck drivers only) In accordance with the Department of Transportation Motor Carrier Safety Regulations, Section 382.413, information concerning alcohol and controlled substances for the past 2 years; Verification of my academic and/or professional credentials; and information and/or copies of documents from any military service records.

I understand that an “investigative consumer report” may include information as to my character, general reputation, personal characteristics, and mode of living which may be obtained by interviews with individuals with whom I am acquainted or who may have knowledge concerning any such items of information.

I agree that a copy of this authorization has the same effect as an original.

hereby release and hold harmless any person, firm, or entity that discloses matters in accordance with this authorization, as well as Gold-Eagle Cooperative / CORN, LP from liability that might otherwise result from the request for use of and/or disclosure of any or all of the foregoing information.

I understand and acknowledge that under provision of the Fair Credit Reporting Act I may request a copy of any consumer report from the consumer reporting agency that compiled the report, after I have provided proper identification.

I hereby authorize Gold-Eagle Cooperative / CORN, LP to obtain and prepare an investigative consumer report as set forth above, as part of its investigation of my employment application. This authorization shall remain in effect over the course of my employment. Reports may be ordered periodically during the course of my employment.

Required field

By submitting this form you are opting in to receive email and/or text communications from Barchart for related product, service or company information, updates and announcements. You can unsubscribe at anytime. View our Privacy Policy.