Online Driver Application

*Note – ALL fields are required. This form is secured in a fully encrypted program.

Applying for:
Name:
Phone: (format: xxx-xxx-xxxx)
Date of Birth:
Social Security #: (format: xxx-xx-xxxx)
Email:
Cell Phone: (format: xxx-xxx-xxxx)
Current Address:
City:      State:      Zip:
How Long:
List all addresses other than the current address that you have resided in during the past 3 years, and how long you lived there:
Previous Address:
City:      State:     Zip:
How Long:
Previous Address:
City:     State:      Zip:
How Long:
Previous Address:
City:      State:      Zip:
How Long:
Have you ever worked for Hanke Trucking, Inc. before?: Yes
Why did you leave?:
Who referred you to Hanke Trucking, Inc. or what publication did you see our ad in?:

LICENSE INFORMATION

Has your license, permit or privilege to operate a motor vehicle ever been denied,
revoked or suspended?:
Yes
IF Yes, please explain:
Show the exact name as shown on your current CDL:
List all drivers licenses held in the past 3 years:
STATE LICENSE NO. CLASS/TYPE ENDORSEMENTS/RESRICTIONS EXP. DATE

DRIVING INFORMATION

Driving Experience Check YES or NO for each type of vehicle shown below.
Show the approximate month/year you began driving that class CMV and the month/year you last drove that class.
Show the approximate total career miles you have driven for each class.

TYPE OF EQUIPMENT YES/NO TYPE OF
TRAILER
FROM (M/Y) TO (M/Y) APPROX #
OF MILES
STRAIGHT TRUCK
TRACTOR & SEMI TRAILER
TRACTOR & 2 TRAILERS
BUS/MOTOR COACH # of Passengers:
OTHER TYPE CMV Explain:
List all accidents you have been involved in during the past 3 years, regardless of severity, fault or type of vehicle driven.
IF NO ACCIDENTS, CHECK BOX BELOW.
DATE LOCATION
(CITY/STATE)
TYPE ACCIDENT #
INJURED
#
FATALITIES
TYPE
VEHICLE
DRIVEN
EMPLOYMENT
RELATED
(Y/N)
List all traffic violations for which you have been convicted, forfeited bond or collateral during the past 3 years (other than parking).
IF NO VIOLATIONS, CHECK BOX BELOW.
I have not been been convicted, forfeited bond or collateral due to traffic violations in the past 3 years.
DATE STATE VIOLATION PENALTY TYPE VEHICLE
If you graduated from Truck Driving School please indicate the name of the school, City/State and year of graduation:

EMPLOYMENT HISTORY

List all employment during the past 3 years, beginning with your present or most recent position. If you worked for a fleet operator or you were an owner operator, show the company you had the vehicle leased to or were qualified to drive for. In addition, you must show all positions you were qualified to drive a commercial motor vehicle for the past 10 years. Please be sure to list all information including the reason for leaving.
EMPLOYER
Name:
Address:
City: State:  Zip:
Contact Person: Phone #:
Were you subject to the FMCSR's while employed?: Yes
DATE
To (M/Y):
From (M/Y):
Position Held:
Salary/Wage:
Reason for leaving:
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol test requirements of 49 CFR 40?: Yes
EMPLOYER
Name:
Address:
City: State:  Zip:
Contact Person: Phone #:
Were you subject to the FMCSR's while employed?: Yes
DATE
To (M/Y):
From (M/Y):
Position Held:
Salary/Wage:
Reason for leaving:
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol test requirements of 49 CFR 40?: Yes
EMPLOYER
Name:
Address:
City: State:  Zip:
Contact Person: Phone #:
Were you subject to the FMCSR's while employed?: Yes
DATE
To (M/Y):
From (M/Y):
Position Held:
Salary/Wage:
Reason for leaving:
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol test requirements of 49 CFR 40?: Yes
EMPLOYER
Name:
Address:
City: State:  Zip:
Contact Person: Phone #:
Were you subject to the FMCSR's while employed?: Yes
DATE
To (M/Y):
From (M/Y):
Position Held:
Salary/Wage:
Reason for leaving:
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol test requirements of 49 CFR 40?: Yes
EMPLOYER
Name:
Address:
City: State:  Zip:
Contact Person: Phone #:
Were you subject to the FMCSR's while employed?: Yes
DATE
To (M/Y):
From (M/Y):
Position Held:
Salary/Wage:
Reason for leaving:
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol test requirements of 49 CFR 40?: Yes
EMPLOYER
Name:
Address:
City: State:  Zip:
Contact Person: Phone #:
Were you subject to the FMCSR's while employed?: Yes
DATE
To (M/Y):
From (M/Y):
Position Held:
Salary/Wage:
Reason for leaving:
Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol test requirements of 49 CFR 40?: Yes
BE SURE THAT YOU HAVE LISTED ALL EMPLOYMENT FOR THE PAST 3 YEARS AND DRIVING JOBS FOR THE PAST 10 YEARS!

Click here to download Release Forms
FAX your release forms to 262-644-8342.

In accordance with 49 CFR part 391.21(b) 10 and 391.21(d), the following information is being provided to you prior to the completion and/or acceptance of an application for driver qualification.

This includes a Summary of Your Rights under the Fair Credit Reporting Act - PRINT OR SAVE FOR YOUR RECORDS