Drivers Employment Application

Please fill out the form below to apply for Employment as a Driver.
Or
Download the PDF and send the completed document to [email protected]/strong>

Required documents for DSPS CDL Applicants:

Copy of a Current Driver’s License

Copy of Current Motor Vehicle Report

Copy of Current Medical Certificate Card

Complete the below DSPS Application

Driver Application
COMPANY NAME: DS Pipe & Steel Supply, LLC
LOCATION: Region/District/Branch:
COMPANY ADDRESS: 1301 Wicomico Street, Baltimore, MD 21230

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make such investigations and inquires of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liabilily in responding to inquiries and releasing informalion in connection with my application. In the event of employment, | understand that false or misleading information given in my application or interview(s) may result in discharge. | understand, also, that I am required to abide by all rules and regulations of the Company. “I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacled, for the purpose of investigating my safely performance history as required by 49 CFR 391.23(d) and (e). I understand that | have the right lo:

Review information provided by current/previous employers;

Have errors in the informalion corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and

Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and | cannot agree on the accuracy of the information."

Driver Applicant's Signature:

Date:

Name: *

Applicant ID #:

Phone #:

Date of Birth*:

Last 3 years of residency required

Address:

Years of residency:

Address:

Years of residency:

Address:

Years of residency:

Employment History

All applicants wishing to drive in interstate commerce must provide the following information on all employers during the preceding three years. You must give the same information for all employers for whom you have driven a commercial vehicle seven years prior to the initial three years (total of ten employment record).

You are required to list the complete mailing address: street number and name, city, state and zip code.

Current or Last Employer

Name:

Phone Number:

Street Address:

City:

State:

Zip:

Position Held:

From:

To:

Reasons for Leaving:

Were you subject to the FMCSRs** while employed? YesNo

Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? YesNo

*Account for Period Between Jobs - Include date and reason:

Second Last Employer

Name:

Phone Number:

Street Address:

City:

State:

Zip:

Position Held:

From:

To:

Reasons for Leaving:

Were you subject to the FMCSRs** while employed? YesNo

Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? YesNo

*Account for Period Between Jobs - Include date and reason:

Third Last Employer

Name:

Phone Number:

Street Address:

City:

State:

Zip:

Position Held:

From:

To:

Reasons for Leaving:

Were you subject to the FMCSRs** while employed? YesNo

Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? YesNo

*Account for Period Between Jobs - Include date and reason:

*Any gaps in employment and/or unemployment must be explained.
**The Federal Motor Carrier Safety Regulations (FMCSRs) 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.

Driving Experience

If no driving experience in the past 3 years, check here:

Straight Truck Experience

Type of Equipment:

From Date:

To Date:

Approximate Number of Miles:

Tractor & Semi-Trailer

Type of Equipment:

From Date:

To Date:

Approximate Number of Miles:

Tractor -- Two Trailers

Type of Equipment:

From Date:

To Date:

Approximate Number of Miles:

Tractor -- Three Trailers

Type of Equipment:

From Date:

To Date:

Approximate Number of Miles:

Motor Coach - School Bus (Greater than 8 Passengers)

From Date:

To Date:

Approximate Number of Miles:

Motor Coach - School Bus (Greater than 15 Passengers)

From Date:

To Date:

Approximate Number of Miles:

Other

Type of Equipment:

From Date:

To Date:

Approximate Number of Miles:

Accident History (3 Years)

Accident 1

Date:

Nature of Accident:

Number of Fatalities:

Number of Injuries:

Hazardous Materials Spill?:

Accident 2

Date:

Nature of Accident:

Number of Fatalities:

Number of Injuries:

Hazardous Materials Spill?:

Accident 3

Date:

Nature of Accident:

Number of Fatalities:

Number of Injuries:

Hazardous Materials Spill?:

Traffic Convictions and Forfietures (3 Years)

Conviction 1

Date Convicted:

Violation:

State of Violation:

Penalty:

Conviction 2

Date Convicted:

Violation:

State of Violation:

Penalty:

License Information
Section 363.21 FMCSR states “No person who operates a commercial motor vehicle shall at any time have more than one driver's license”. | certify that | do not have more than one motor vehicle license, the information for which is listed below.

State:

License Number:

License Expiration:

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?YesNo

If Yes, please give details:

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?YesNo

If Yes, please give details:

Application Certification
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Driver Applicant's Signature:

Date:

Telephone #:

Cellular/Other Phone #:

Email Address: *

Position(s) applied for:

Date of Application:

Referral Source (e.g., Walk-in, Job Posting, Company's Website, etc.):

If necessary, best time to call you is: HomeCellular/Other

May we contact you at work? YesNo

If yes, work number and best time to call:

If you are under 18 and it is required, can you furnish a work permit? N/AYesNo

If no, please explain:

Have you submitted an application here before? YesNo

If yes, give date(s) and position(s):

Have you ever been employed here before? YesNo

If yes, give dates:

Is this application a request for reemployment following an extended military leave of absence from this company? YesNo

Are you lawfully authorized to work in the United States? YesNo

Date available for work:

What is your desired salary range or hourly rate of pay?

Type of employed desired: Full-TimePart-TimeEducational Co-OpSeasonalTemporary

Will you relocate if job requires it? YesNo

Will you travel if job required it? YesNo

If they have been explained to you, are you able to meet the attendance requirements of the position? N/AYesNo

Will you work overtime if required? YesNo

If no, please explain [texarea explain-reason-for-not-able-to-work-overtime]

Are you able to perform the "essential functions" of the job for which you are applying (with or without reasonable accommodation)?
This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.
YesNoNeed more information about the job's essential functions to respond

Driver's license number required if driving may be required in the job for which you applying:

Have you been bonded? YesNo

Have you ever pleaded "guilty" or "no contest" to, or been convicted of a crime?
NOTE: Answering "yes" to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account. You are not obligated to disclose expunged charges.
YesNo

If yes, please date(s) and details:

Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way, restrict your ability to work for our company? YesNo

If yes, please explain:

Employment History

Employer:

Telephone #:

Street Address:

City:

State:

Starting Job Title/Final Job Title:

Immediate Supervisor and Title (for most recent position held):

May be contact for reference? YesNoLater

Email:

Why did you leave?

Summarize the Type of Work Performed and Job Responsibilities:

What did you like most about your position?

What were the things you liked least about your position?

Date Employed: to

Compensation (Starting):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Compensation (Final):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Employer:

Telephone #:

Street Address:

City:

State:

Starting Job Title/Final Job Title:

Immediate Supervisor and Title (for most recent position held):

May be contact for reference? YesNoLater

Email:

Why did you leave?

Summarize the Type of Work Performed and Job Responsibilities:

What did you like most about your position?

What were the things you liked least about your position?

Date Employed: to

Compensation (Starting):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Compensation (Final):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Employer:

Telephone #:

Street Address:

City:

State:

Starting Job Title/Final Job Title:

Immediate Supervisor and Title (for most recent position held):

May be contact for reference? YesNoLater

Email:

Why did you leave?

Summarize the Type of Work Performed and Job Responsibilities:

What did you like most about your position?

What were the things you liked least about your position?

Date Employed: to

Compensation (Starting):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Compensation (Final):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Employer:

Telephone #:

Street Address:

City:

State:

Starting Job Title/Final Job Title:

Immediate Supervisor and Title (for most recent position held):

May be contact for reference? YesNoLater

Email:

Why did you leave?

Summarize the Type of Work Performed and Job Responsibilities:

What did you like most about your position?

What were the things you liked least about your position?

Date Employed: to

Compensation (Starting):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Compensation (Final):

Compensation Type: HourlySalary

Commission/Bonus/Other Compensation:

Explain any gaps in your employment, other than those due to personal illness, injury, or disability:

If not addressed above, have you ever been fired or asked to resign from a job? YesNoLater

If yes, please explain:

Skills and Qualifications

Summarize any special training, skills, languages, licenses, and/or certifications that may assist you in performing the position for which you are applying:

Computer Skills (Include software titles and level of experience, such as basis, intermediate, or advanced.)

Word ProcessingSpreadsheetPresentationE-mailInternet

Please highlight any other computer skills below: :

Educational Background

Starting with your most recent school attended, provide the following information:

School (include City and State) # of Years Completed Completed GPA Class Rank Major/Minor

DiplomaGEDDegreeCertificationOther

DiplomaGEDDegreeCertificationOther

DiplomaGEDDegreeCertificationOther

DiplomaGEDDegreeCertificationOther

References

List names and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.

Name Title Relationship to You Telephone E-mail # of Years Known

Related Information

When answering these questions, please exclude any information that would reveal race, religion, color, sex (including pregnancy), age, ancestry or national origin, disability, marital status, sexual orientation, gender identity, genetic information, or other similarly protected status.

To what job-related organizations (professional, trade, etc.) do you belong?

List special accomplishments, publications, awards, etc.:

List any relevant volunteer work:

Is there any other job-related information you want us to know about you?

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete, and correct.
I expressly authorize, without reservation, the employer, its representatives, employees, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resumé, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees, or representatives, for seeking, gathering, and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations, or organizations for furnishing such information about me.
I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, or federal law.
I understand that this application remain current for only 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.
If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time with or without cause with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period of definite duration. I understand that no supervisor or representative of the employer is to make any assurances to the contrary and that no implied oral or written agreements contrary to the forgoing express language are value unless they are in writing and signed by the employer's president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
I understand that reasonable safeguards will be taken to protect all personal information provided or obtained in conjunction with this application for employment. My personal information may be shared with the employer's affiliate(s) and third parties engaged by the employer to perform services for the employer. Any personal information shared with an affiliate or third party is to be used solely to perform the services requested by the employer.
UNDER MARYLAND LAW, AN EMPLOYER MAY NOT RWQUIRE OR DEMAND, AS A CONDITION OR EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYEMTN, THAT AN INDIVIDUAL SUBJECT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEAMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.
This Company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis or his or her race, religion, color, sex (including pregnancy), age, ancestry or national origin, disability, marital status, sexual orientation, gender identity, genetic information, or any other protected status under applicable federal, state, or local law.
I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICATION STATEMENT.

I certify that I have ready, fully understand and accept all terms of the foregoing Applicant Statement.

Name of Applicant

Date

Signature:

Δ

School (include City and State)	# of Years Completed	Completed	GPA Class Rank	Major/Minor
		DiplomaGEDDegreeCertificationOther
		DiplomaGEDDegreeCertificationOther
		DiplomaGEDDegreeCertificationOther
		DiplomaGEDDegreeCertificationOther

Required documents for DSPS CDL Applicants:

Driver Application

Last 3 years of residency required

Employment History

Current or Last Employer

Second Last Employer

Third Last Employer

Driving Experience

Straight Truck Experience

Tractor & Semi-Trailer

Tractor -- Two Trailers

Tractor -- Three Trailers

Motor Coach - School Bus (Greater than 8 Passengers)

Motor Coach - School Bus (Greater than 15 Passengers)

Other

Accident History (3 Years)

Accident 1

Accident 2

Accident 3

Traffic Convictions and Forfietures (3 Years)

Conviction 1

Conviction 2

License Information

Application Certification

Employment History

Skills and Qualifications

Educational Background

References

Related Information

Applicant Statement

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