Renegade Transport, LLC

Drivers Application

Thank you for your interest in driving for Renegade Transport LLC.

We lease on owner operators of ¾ and 1 ton diesel trucks, to transport all types of trailers across the United States and Canada

We are always looking for top quality drivers to enhance our image with our customers by providing friendly, efficient and professional customer service.

Below is a list of requirements necessary to be eligible to drive for Renegade Transport LLC.

If you have any questions, please call us at 580-470-8303.

If not, please fill out the application below and submit.

We look forward to reviewing your application, and hope to began a long and prosperous business relationship.

Position(s) applied for:

Name:

Last

First

MI

List your addresses of residency for the past 3 years.

Current Address:

Street:

City:

State:

Zip:

How Long?

Current Phone Number:

Previous Addresses: (if any)

Street:

City:

State:

Zip:

How Long?

Street:

City:

State:

Zip:

How Long?

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

Date of Birth:

Can you provide proof of age?

Have you worked for this company before?

Dates:

Reasons for leaving

Are you employed?

If not, how long since leaving last employment?

Who referred you?

Rate of pay expected?

Is there any reason you might be unable to perform the functions of the job for which you have applied as described in the attached job description?

Yes No

If yes, explain if you wish

Employment History

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code.

Applicants to drive a commercial motor vehicle* in intrastate commerce shall also provide an additional 7 years’ information on those employers for whom the applicant operated such vehicle. (NOTE: List employers in reverse order starting with the most recent. Add another sheet if necessary.)

*Includes vehicles having a GVWR of 26,001 lbs or more, vehicles designed to transport 15 or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring signage.

Employer

Name:

Street:

City:

State:

Zip:

Phone:

Contact Person:

Date (Month and Year):

Position Held:

Salary/Wage:

Reasons for leaving:

Employer

Name:

Street:

City:

State:

Zip:

Phone:

Contact Person:

Date (Month and Year):

Position Held:

Salary/Wage:

Reasons for leaving:

Employer

Name:

Street:

City:

State:

Zip:

Phone:

Contact Person:

Date (Month and Year):

Position Held:

Salary/Wage:

Reasons for leaving:

Accident records for past 3 years or more (attach sheet if more space is needed). If none, write NONE.

Traffic convictions and forfeitures for the past 3 years (other than parking violations). If none, write NONE.

Education

Highest grade completed:

High School:

College:

EXPERIENCE AND QUALIFICATIONS~DRIVER LICENSES

Have you ever been denied a license, permit or privilege to operate a motor vehicle? Yes No

Has any license, permit or privilege ever been suspended or revoked? Yes No

If the answer to either A or B is yes, give details

Driving Experience If none, write NONE.

List states operated in for last five years:

Show special courses or training that will help you as a driver:

Which safe driving awards do you hold and from whom?

EXPERIENCE AND QUALIFICATIONS - OTHER

Show any trucking, transportation or other experience that may help in your work for this company

List courses and training other than shown elsewhere in this application

List special equipment or technical materials you can work with (other than those already shown)

To be read and signed by applicant 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.

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 liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

Applicant’s signature (name)

Date