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Are you at least 23 years old?
Yes
No
Years Tractor Trailer Experience within the last 3 yrs
Less Than 1 Year
1 Year
2 Years
3+ Years
Do you have a Class A CDL?
Yes
No
Endorsements/Certifications
Hazmat
Tanker
TWIC
Loading Rack Card
None
Other
Number of Preventable Accidents last 3 Years?
0
1
2
3+
Number of Moving Violations last 3 Years?
0
1
2
3+
Have you been convicted of Careless or Reckless Driving in last 3 years?
Yes
No
DUI/DWI last 5 Years?
Yes
No
Have you been convicted of a Felony in the last 7 Years?
Yes
No
Have you ever tested positive for Drug/Alcohol in the last 5 years?
Yes
No
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