Last Name

First Name

Middle Name

Address Line 1

Address Line 2

State

City

ZIP Code

Phone Number

Email Address

Driver's License #

How did you learn about Flyte Waste? How did you learn about Flyte Waste? *Search EngineSocial MediaEmailWebsiteReferred by a Friend/FamilyWord of MouthOther

Who can we thank for referring you?

Are you a US citizen, permanent resident, or a foreign national with authorization to work in the United States? Are you a US citizen, permanent resident, or a foreign national with authorization to work in the United States? *YesNo

Available Start Date

Position Sought

Desired Pay Range

Currently Employed? Currently Employed? *YesNo

DOT Physical Exam Date

DOT Expiration Date

Are you a previous employee of Flyte Waste Removal? Are you a previous employee of Flyte Waste Removal? *YesNo

Start Date

End Date

Reason for Leaving

High School Name & Location

Did you graduate? Did you graduate? *YesNo

Did you attend college or university? Did you attend college or university? *YesNo

College / University Name & Location

Did you graduate? Did you graduate? *YesNo

Field of Study

Did you attend trade school or receive specialized training? Did you attend trade school or receive specialized training? *YesNo

Trade School Name / Training Organization & Location

Trade School Program / Name of Training

Did you graduate / complete training? Did you graduate / complete training? *YesNo

Please detail your areas of highest proficiency, special skills and or trainings that may contribute to your abilities in performing the position for which you are applying.

Do you have previous work experience? Do you have previous work experience? *YesNo, this would be my first job

Employer Name

Employer Location

Employer Phone Number

Start Date

End Date

Position / Title

Job Notes / Tasks Performed

Reason for Leaving

Were you subject to the FMCSRs while employed here? Were you subject to the FMCSRs while employed here? Yes No

Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

Do you have additional employment history? Do you have additional employment history? *YesNo

Employer Name

Employer Location

Employer Phone Number

Start Date

End Date

Position / Title

Job Notes / Tasks Performed

Reason for Leaving

Were you subject to the FMCSRs while employed here? Were you subject to the FMCSRs while employed here? Yes No

Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

Do you have additional employment history? Do you have additional employment history? *YesNo

Employer Name

Employer Location

Employer Phone Number

Start Date

End Date

Position / Title

Job Notes / Tasks Performed

Reason for Leaving

Were you subject to the FMCSRs while employed here? Were you subject to the FMCSRs while employed here? Yes No

Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

Do you have additional employment history? Do you have additional employment history? *YesNo

Employer Name

Employer Location

Employer Phone Number

Start Date

End Date

Position / Title

Job Notes / Tasks Performed

Reason for Leaving

Were you subject to the FMCSRs while employed here? Were you subject to the FMCSRs while employed here? Yes No

Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

Do you have additional employment history? Do you have additional employment history? *YesNo

Employer Name

Employer Location

Employer Phone Number

Start Date

End Date

Position / Title

Job Notes / Tasks Performed

Reason for Leaving

Were you subject to the FMCSRs while employed here? Were you subject to the FMCSRs while employed here? Yes No

Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Was your job designed as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40? Yes No

Do you have additional employment history? Do you have additional employment history? *YesNo

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Have you ever been in the armed forces? Have you ever been in the armed forces? *YesNo

Are you still an active member of the Armed Forces? Are you still an active member of the Armed Forces? *YesNo

Date of Enlistment

Date of Discharge

Type of Discharge Type of Discharge *HonorableDishonorable

Are you a member of the National Guard / Reserves? Are you a member of the National Guard / Reserves? *YesNo

MOS/Specialty

List special courses/training completed (PTD/DDC, HAZMAT, et al.)

List any Safe Driving Awards you hold and from whom:

Have you been in an accident in the past three (3) years? Have you been in an accident in the past three (3) years? *YesNo

Date of Accident

Nature of Accident (Head on, rear end, et al.)

Location of Accident

Number of Fatalities

Add another accident? Add another accident? *YesNo

Number of Injured Persons

Date of Accident

Nature of Accident (Head on, rear end, et al.)

Location of Accident

Number of Fatalities

Number of Injured Persons

Add another accident? Add another accident? *YesNo

Date of Accident

Location of Accident

Nature of Accident (Head on, rear end, et al.)

Number of Fatalities

Number of Injured Persons

Add another accident? Add another accident? *YesNo

Upload Additional Accident Details File InputChoose FilesNo Files ChosenAccepted file types: xcf, doc, mka. Max. file size: 1 MB

Do you have any traffic convictions and forfeitures from the past three (3) years? Exclude parking violations. Do you have any traffic convictions and forfeitures from the past three (3) years? Exclude parking violations. *YesNo

Date

Location

Charge

Penalty

Add another traffic conviction and forfeiture? Add another traffic conviction and forfeiture? *YesNo

Date

Location

Charge

Penalty

Add another traffic conviction and forfeiture? Add another traffic conviction and forfeiture? *YesNo

Date

Location

Charge

Penalty

Add another traffic conviction and forfeiture? Add another traffic conviction and forfeiture? *YesNo

Upload Additional Traffic Convictions and Forfeitures Details File InputChoose FilesNo Files ChosenAccepted file types: xcf, doc, mka. Max. file size: 1 MB

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

Please provide additional details

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

Please provide additional details

Have you ever been convicted of a crime (misdemeanor or felony)? Have you ever been convicted of a crime (misdemeanor or felony)? *YesNo

Please provide additional details

Reference Name

Phone Number

Reference Name

Phone Number

Reference Name

Phone Number

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