Apply Online

If you are interested in becoming a member of the TriState team please take a moment and send us a online application. Our staff will review your application and get in touch with you as soon as possible.
 

*To view minimum driver requirements, click here.

 

Name of Recruiter:

 

Personal Information

 

First Name:

Middle Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Country:
Home Number:
Cell Number:
Email Address:
Date of Birth: (m/d/yyyy)

Social Security #

Address For Past Three Years

Street:  

City:  

State:  

Zip:  

Country:  

Number of Years:  

Street:  

City:  

State:  

Zip:  

Country:  

Number of Years:  

 
Emergency Contact
 

Name:  

Phone:  


Are you a US citizen?
Yes    No

If not a US citizen, do you have a Permanent Resident card?
Yes    No


 

 

Driver License #:

Driver License State:

Driver License Issue Date:

Driver License Exp:

Do you have a CDL?

Haz-Mat Endorsement?

Yes    No

Have you ever failed a drug test?

Yes    No

Has your driver's license ever been suspended for any reason?

Yes    No

Ever have any criminal convictions?

Yes    No

If Yes, please provide full details:

Have you had any other Driver's licenses besides your current one above in the last 3 years?

Yes    No

List all Driver's licenses besides above you have held in the last 3 years. 
Please list states and driver's license numbers.


Your Status:

If driving for a truck owner, Please specify the following:

Truck Owner Name:

Truck Number:


Truck Type:

Truck Year:

(yyyy)

Truck Model


Number of moving violations in the last 3 years:

Number of accidents in the last 3 years:

Employment History (List all employment for past 10 years)

Present Employer:

 

Employer Name:

Dates Employed:

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:
Please include street ,city ,state, and zip code.

Employer's Phone:

Position Held:

Reason for Leaving:


If you were a driver, please provide the following information:

Equipment:

Straight Truck 
Semi
Other

If Other, Please specify:

If Tractor, Please specify trailer size:


Previous Employment:

 
   

Employer Name:

Dates Employed:

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:
Please include street ,city ,state, and zip code.

Employer's Phone:

Position Held:

Reason for Leaving:

   
   

Employer Name:

Dates Employed:

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:
Please include street ,city ,state, and zip code.

Employer's Phone:

Position Held:

Reason for Leaving:

   
   

Employer Name:

Dates Employed:

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:
Please include street ,city ,state, and zip code.

Employer's Phone:

Position Held:

Reason for Leaving:

   
   

Employer Name:

Dates Employed:

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:
Please include street ,city ,state, and zip code.

Employer's Phone:

Position Held:

Reason for Leaving:

   
   

Employer Name:

Dates Employed:

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:
Please include street ,city ,state, and zip code.

Employer's Phone:

Position Held:

Reason for Leaving:

Employer Name:  

Dates Employed:  

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:  
Please include street, city,   state, and zip code.  

Employer's Phone:  

Position Held:  

Reason for Leaving:  

 
 

Employer Name:  

Dates Employed:  

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:  
Please include street, city,   state, and zip code.  

Employer's Phone:  

Position Held:  

Reason for Leaving:  

 
 

Employer Name:  

Dates Employed:  

From: (m/d/yyyy)
     To:(m/d/yyyy)

Employer's Address:  
Please include street, city,   state, and zip code.  

Employer's Phone:  

Position Held:  

Reason for Leaving:  


If you were ever a driver, please provide the following information:

Equipment:

Straight Truck 
Semi
Other

If Other, Please specify:

If Tractor, Please specify trailer size:

 
Statement of Understanding
I certify that I personally completed this application and that all of the information is true and correct. I authorize TriState  Expedited Services Inc to obtain any and all information (including, but not limited to, work history, alcohol/controlled substance testing, training records, and criminal history) from previous and current employer(s), Medical Review Officer or their agent, DAC services, or other consumer reports, in accordance with State and Federal laws. I authorize my previous and current employer(s) to release any information requested by TriState  Expedited Services Inc and hold them harmless of all liability from release of said information. I have read and understand the above statements and acknowledge by affixing my digital signature below.
 

I have read and understand the above statements:
Yes    No

Your Full Name:


 

   

 

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