General Shelters of Texas Driver Application

General Shelters of Texas Driver Application
Applications are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or in the presence of a non-related medical condition or disability.

Position Applying For:

First Name: Middle Name: Last Name: Date:

Street Address: City: State: Zip:

Phone Number: Social Security #: Email:

Driver's License #: State: Type: Expiration Date:

Emergency Contact: Emergency Contact Number:

Driving Experience

Class of Equipment Type of Equipment Dates of Operation Total Miles of Operation

Bus Type: From: To: Miles:

Straight Truck Type: From: To: Miles:

Tractor/Semi-Trailer Type: From: To: Miles:

Other Type: From: To: Miles:

Safe driving awards you now hold and from whom?

Accident Record for the Past 3 Years

Attach additional sheets if neeeded below

Accident Date of Accident Nature of Accident Number of Fatalities or Injuries if Any

(head-on,rear-end,upset,etc.)

Accident 1 Date: Nature: Number of Injuries:

Accident 2 Date: Nature: Number of Injuries:

Accident 3 Date: Nature: Number of Injuries:

Employment History

Start with your present job. Include military assignments and other volunteer activities.

Employer 1:

Address:

City: State: Zip:

Phone Number: Supervisor's Name

Job Title: Reason for Leaving:

From Date: To Date:

Employer 2:

Address:

City: State: Zip:

Phone Number: Supervisor's Name

Job Title: Reason for Leaving:

From Date: To Date:

Employer 3:

Address:

City: State: Zip:

Phone Number: Supervisor's Name

Job Title: Reason for Leaving:

From Date: To Date:

Qualifications

Please give any further information which may be helpful to us in considering your qualifications.

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