EAGLE EXPRESS INC.

5601 Belleville Road, Canton, MI 48188
Phone 800-933-0215 x1061 Fax 734-397-1461

DRIVER
APPLICATION FOR EMPLOYMENT

(Please answer all questions)

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disability.

Position applied for:

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Date of application:

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First Name(*)

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Last Name(*)

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Middle Initial

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Address(*)

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State(*)

Please select your state

City(*)

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Zip (*)

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Phone(*)

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E-mail Address(*)

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Date of Birth:(*)

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Do you have the legal right to work in the United States?

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Can you provide proof of age?(*)

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Is there any reason you might be unable to perform the functions of the job for which you have applied?

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ADDRESSES FOR PAST THREE YEARS

Former address 1:(*)

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Former address 2:

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PREVIOUSLY EMPLOYED WITH EAGLE EXPRESS INC.?

Have you ever worked for this company before?(*)

YesNo Invalid Input

When?

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Position held

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Rate of Pay:

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Reason For Leaving?

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How did you hear about Eagle Express Inc.?

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MUST SUPPLY 10 YEARS OF EMPLOYMENT HISTORY

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. Applicants to drive a commercial motor vehicle in intrastate or interstate commerce shall also provide an additional 7 years of information on those employers for whom the applicant operated such vehicle.

(Note: List employers in reverse order starting with the most recent.)

EMPLOYER 1

Please list current or most recent employer.

From:

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To:

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Name:(*)

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Phone:

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Address:

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Position held:

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Supervisor:

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Duties:

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Reason for leaving:

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EMPLOYER 2

Please list 2nd most recent employer.

From:

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To:

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Name:

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Phone:

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Address:

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Position:

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Supervisor:

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Duties:

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Reason for leaving:

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EMPLOYER 3

Please list 3rd most recent employer.

From:

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To:

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Name:

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Phone:

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Address:

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Position held:

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Supervisor:

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Duties:

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Reason for leaving:

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EMPLOYER 4

Please list 4th most recent employer.

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To:

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Name:

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Phone:

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Address:

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Position held:

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Supervisor:

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EMPLOYER 5

Please list 5th most recent employer.

From:

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To:

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Name:

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Phone:

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Address:

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Position held:

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Supervisor:

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Duties:

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Reason for leaving:

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EMPLOYER 6

Please list 6th most recent employer.

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Name:

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Phone:

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Address:

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Position held:

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Supervisor:

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Reason for leaving:

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EAGLE EXPRESS INC.

DRIVER
APPLICATION FOR EMPLOYMENT

ADDRESSES FOR PAST THREE YEARS

PREVIOUSLY EMPLOYED WITH EAGLE EXPRESS INC.?

MUST SUPPLY 10 YEARS OF EMPLOYMENT HISTORY

EMPLOYER 1

EMPLOYER 2

EMPLOYER 3

EMPLOYER 4

EMPLOYER 5

EMPLOYER 6

EXPERIENCE AND QUALIFICATIONS

Have you ever been...

TO BE READ AND SIGNED BY APPLICANT

EAGLE EXPRESS INC.

DRIVER APPLICATION FOR EMPLOYMENT

ADDRESSES FOR PAST THREE YEARS

PREVIOUSLY EMPLOYED WITH EAGLE EXPRESS INC.?

MUST SUPPLY 10 YEARS OF EMPLOYMENT HISTORY

EMPLOYER 1

EMPLOYER 2

EMPLOYER 3

EMPLOYER 4

EMPLOYER 5

EMPLOYER 6

EXPERIENCE AND QUALIFICATIONS

Have you ever been...

TO BE READ AND SIGNED BY APPLICANT

DRIVER
APPLICATION FOR EMPLOYMENT