Driver Application
BWI Haul Solutions — CDL Class A Positions Available
Company Information
Company
Client
Company Address
Hiring Contact First Name
Hiring Contact Last Name
Hiring Contact Phone
Hiring Contact Email
Date of Application
Applicant Information
First Name
*
Middle Name
Last Name
*
Phone
*
Email
*
Social Security #
*
Date of Birth
*
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
Year
Position Applied For
Date Available to Work
*
Legally authorized to work in the US?
*
Yes
No
Medical Certification
Medical Examination Report MCSA-5875
*
National Registry Number
*
MEC Expiration Date
*
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
Year
Current Address
Street Address
*
City
*
State
*
ZIP Code
*
Years at Address
*
Mailing address same as current?
*
Yes
No
Street Address
City
State
ZIP Code
Years at Address
Driver's License
Driver's License (Front)
*
License Number
*
License State
*
Select state
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
License Type
*
Select type
CDL
Personal
License Class
*
Select class
A
B
C
Endorsements
None
Tank Vehicles
Hazardous Materials
Passenger
School Bus
Double/Triple Trailers
Air Brake
Combination
Expiration Date
*
Previously held other licenses?
*
Yes
No
CDL Experience
CDL held for more than 1 year?
*
Yes
No
Entry-Level Training Certificate (if applicable)
Truck experience — check all that apply
Straight Truck experience?
Yes
No
Equipment Type
Approximate Miles
Date From
Date To
Tractor & Semi-Trailer experience?
Yes
No
Equipment Type
Approximate Miles
Date From
Date To
Tractor & 2 Trailer experience?
Yes
No
Equipment Type
Approximate Miles
Date From
Date To
Submit Application
