Sugar House Movers & Storage - Bekins Van Lines - Salt Lake City, Utah: Employment Application

Current Openings!

Local Driver (Household Goods) Local Driver (Special Products) Regional Driver (Special Products)

Other openings may be available but not necissarily posted.

Driver Application for Employment

Applicant must read and sign before submitting this application

Signature of Applicant *

Date *

Name (First, Middle, Last) *

Phone Number *

Email Address

*Current Address

*If at the above residence less than three years, list below all residences for the past three years.

Previous Addresses

Date of Birth (MM/DD/YYYY)(Answer only if applying for driving position)

In case of emergency notify:

Position applying for?

Type of status seeking

Temporary Part Time Full Time

Who referrred you?

Rate of pay expected?

Have you worked for this company before

If Yes, Dates from and to:

Reason for leaving?

Are you currently employed

If no, how long since leaving your last employment?

Are you a United States Citizen?

If no, are you legally able to work in the United States? Give permanent Visa Number

Can you read, write, and speak the English language?

For Drivers Only: Date of last DOT prescribed physical exam

Highest grade completed

EDUCATION (College, Business, or Trade Schools)

List Name, Location, Dates attended, and Degree/Certificate

EMPLOYMENT - The USDOT requires that driver applicants show all employment for the past ten years. Start with the last or current position, including military experience, and work back. ANY GAPS IN EMPLOYMENT OF 30 DAYS OR MORE MUST BE EXPLAINED

Company 1 (list Company Name, Supervisors Name, Address, Phone No., Position Held, Dates, and Pay Rate)

Reason for Leaving

Company 2 (list Company Name, Supervisors Name, Address, Phone No., Position Held, Dates, and Pay Rate)

Reason for leaving

Company 3 (list Company Name, Supervisors Name, Address, Phone No., Position Held, Dates, and Pay Rate)

Reason for leaving

Company 4 (list Company Name, Supervisors Name, Address, Phone No., Position Held, Dates, and Pay Rate)

Reason for leaving

List Remaining here

Are you over the age of 18?

DRIVING EXPERIENCE & RECORD (DOT Required)

List drivers licenses held in the past three years. Include State, License No. Type, Exp. Date

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

Has any license, permit, or privilege ever been suspended or revoked?

Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations?

Have you ever tested positive on a USDOT required drug or alcohol test?

If you answered "yes" to any of the 4 questions above, give details.

List all violations of vehicle law or ordinance (exclude parking tickets) of which you were convicted or forfeited bond during the past 3 years.

List all motor vehicle accidents during the past 3 years

List states operated in during the last 5 years

List types of equipment operated and dates

List safe driving awards held and who awards were presented by:

List special courses or training that will help you as a driver

Have you ever been bonded?

Name of bonding company

Have you ever been know by any name other than the one shown on this application?

Have you ever been treated by a doctor or hospitalized for a mental disorder, nervous condition, alcoholism, or substance abuse?

Are you currently taking any medication likely to interfere with your ability to operate a motor vehicle safely?

Have you recieved Worker's Compensation or disability income payments?

Do you have physical defects and/or restrictions which preclude you from performin certain jobs?

Are you aware of any physical or mental disability or condition that might prevent you from safely operating a vehicle or from loading or unloading?

Is your travel throughout the United States or Canada restricted in any way?

Are you currently receiving treatment for high blood pressure, epileptic seizures, or diabetes mellitus?

Have you ever been convicted of a felony?

Have you ever been convicted of a misdemeanor?

Have you been incarcerated for a criminal offense during the previous three years?

Are you currently on parole, or reporting probation due to a criminal offense conviction?

If yes to any of the above, explain including dates convicted and charge

Conviction of a crime is not an automatic bar to employment - all circumstances will be considered.

It is understood that potential new employees to Sugar House Van Lines, Inc. are required to pass a drug and alcohol screen, physical exam, and fitness test prior to acceptance of employment. My signature certifies that this application was voluntarily completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge, I further understand any false information contained in the application and which I have provided, may be grounds for immediate rejection of the application or disqualification from Sugar House Van Lines. It is agreed and understood that the employer or his agents may investigate the applicant¿s background to ascertain any and all information of concern to applicant¿s such information . It is also agreed and understood that under the Fair Credit Act, I have been told that this investigation may include and Investigative Consumer Report, including information regarding my character, general reputation, personal characteristics and mode of living. I agree to furnish any additional information and complete such examination as may be required to complete my employment file. Applications are only kept for 30 days.

Applicant's Signature *

Application Date *

( * Required Field )

                                      Your Privacy is assured: At Sugar House Moving & Storage, your personal privacy and the
                                      security  of your information are of primary concern. Under no circumstances will Sugar House
                                      Moving & Storage sell or share any personal information about you to or with any person or
                                      organization except those authorized by you, or as may be required by law or court order. We do
                                      not sell or exchange any email addresses.