Driver Employment Application

Drive For Pacific Truck Lines

Complete the application below in full. It covers the same information required by federal driver-qualification rules (49 CFR 391.21) — residency, license, driving experience, and employment history for the last 3 years.

Applicant Information

01 / 10

First Name *

Middle Name

Last Name *

Phone *

Email *

Date Of Birth *

Social Security # Used for license & employment verification (49 CFR 391.21). Prefer not to email it? Leave blank — dispatch will collect it by phone.

Date Available For Work *

Position Applied For

Legal Right To Work In The U.S.? *

Yes No

Previous Three Years Residency

02 / 10

List every address you've lived at over the past 3 years, most recent first.

Current Address

Street *

City *

State *

Zip Code *

Years At Address *

Mailing address is the same as current address

Previous Addresses

License Information

03 / 10

Federal rule 49 CFR 383.21: a commercial driver may hold only one license. List your current license below.

State *

License # *

Type / Class *

Expiration Date *

Endorsements

Previously Held Licenses (past 3 years, if any)

Driving Experience

04 / 10

Class Of Equipment	Type Of Equipment	Date From	Date To	Approx. Miles (Total)
Straight Truck
Tractor & Semi-Trailer
Tractor & 2 Trailers
Tractor & Tanker
Other

Accident Record — Past 3 Years

05 / 10

No accidents in the past 3 years

Traffic Convictions & Forfeitures — Past 3 Years

06 / 10

Other than parking violations.

No convictions or forfeitures in the past 3 years

Ever been denied a license, permit, or privilege to operate a motor vehicle?

Yes No

If yes, explain

Ever had a license, permit, or privilege suspended or revoked?

Yes No

If yes, explain

Employment History

07 / 10

List employment for the last 3 years (10 years if you've driven commercially before). Explain any gap over 1 month.

Education

08 / 10

Other Qualifications

09 / 10

List any other qualifications you believe should be considered.

Certification & Signature

10 / 10

I authorize Pacific Truck Lines LLC to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with this application.

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

I understand that information regarding my current and/or prior employers may be used, and those employers will be contacted, to investigate my safety performance history as required by 49 CFR 391.23. I understand that I have the right to:

Review information provided by current/previous employers;
Have errors in the information corrected by previous employers, and for those employers to resend corrected information to Pacific Truck Lines LLC; and
Have a rebuttal statement attached to alleged erroneous information if the previous employer and I cannot agree on its accuracy.

This certifies that I completed this application, and that all entries in it are true and complete to the best of my knowledge.

I have read and agree to the statement above, and certify the information in this application is true and complete. *

Type Your Full Legal Name As Your Signature *

Date

Submitting sends your application straight to Pacific Truck Lines dispatch — no email app required. If you'd rather not include your SSN this way, leave it blank and dispatch will collect it by phone.

Automatic submission didn't go through. Use one of the options below to send it directly instead.

Application Summary

Email This Application

Sending by email is not encrypted. If you'd rather not include your SSN over email, leave it out — dispatch will collect it by phone during screening.

Drive For Pacific Truck Lines

Applicant Information

Previous Three Years Residency

License Information

Driving Experience

Accident Record — Past 3 Years

Traffic Convictions & Forfeitures — Past 3 Years

Employment History

Education

Other Qualifications

Certification & Signature

Thanks — your application is in.