Connect Logistics Employment Application

Name *

First

Last

Email *

Telephone *

Street Address *

Town, State and Zip Code *

Do you have reliable transportation to and from work? *

Do you have a valid US Drivers License? *

How many years experience driving a personal vehicle? *

Any at fault accidents in the past 3 years? *

If yes, please list and explain:

Have you ever driven in a professional setting? *

If yes, please list job and type of vehicle driven:

Are you able capable of lifting and carrying objects up to 75 pounds? *

This job may require working weekends and holidays, is this a problem? *

If yes, please explain:

Most Recent Employer Name *

Title/Position Held *

Begin Date - End Date *

Description of Duties/Responsibilities *

Reason For Leaving? *

Supervisor Name *

First

Last

Supervisor Title *

Supervisor Phone: *

May We Contact Supervisor? *

Previous Employer Name

Title/Position Held

Begin Date - End Date

Description of Duties/Responsibilities

Reason For Leaving?

Supervisor Name

First

Last

Supervisor Title

Supervisor Phone:

May We Contact Supervisor?

Title of Completed Degree?

Name of Educational Institution:

Any extra information about yourself that we should take into consideration?

Message