8060 36th Street SE      Exit 256 I-94       Jamestown, ND 58401     Telephone (800) 252-6451

APPLICATION FOR EMPLOYMENT

Applicant Name ____________________________________________  Telephone Number ___________________
                                                     (Street, City, State, Zip Code)

Current Address ________________________________________________________________________________
                                                           (Street, City, State, Zip Code)

Previous Address ______________________________________________________________________________
                                                                                                      (Street, City, State, Zip Code)

Social Security Number _______________________________________ Birth Date _________________________


Drivers License Number ___________________________ State ____________ Expiration Date _______________


Who Referred You? _____________________________________________ Rate of Pay Expected _____________

Truck Driver Job Description and Physical Requirements
Read the following, then sign in the appropriate area below.

     A truck driver may be required to operate his/her vehicle for up to 18 days under all types of weather, traffic, and highway conditions.  A truck driver may be subject to bouncing and jarring due to the "ride" of the truck.  The bouncing and jarring may create stress and compression in the spinal column and back muscles of the driver.
     A secondary requirement of truck driving is the requirement of loading/unloading freight.  This may require the driver to perform heavy lifting and carrying.  Truck loads of 45,000 to 47,000 are routinely made up of smaller packages which weigh as little as 5 to 10 pounds, or as much as 90 to 100 pounds each..  Such loads require stooping, bending, and lifting by the driver.
     Dropping a trailer requires upper body strength to crank the trailer dollies down to lift the trailer off of the fifth wheel plate.  Upper body strength is also required of flatbed truck drivers for chaining and tarping loads.
Sufficient agility is required for the driver to climb onto loading docks and into/onto the trailer.  The driver is also required to crawl under the vehicle in order to perform a thorough pre-trip inspection.
    A driver must be able to meet the minimum physical requirements prescribed by law as stated in the Federal Motor Carrier Safety Regulations.

I feel I can successfully perform the tasks described above.

Signature _________________________________________________________ Date _________


With certain, reasonable accommodations, such as ________________________________________
_______________________________________________________________________________
I can successfully perform the tasks described above.

Signature _________________________________________________________ Date _________

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