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In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquires regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

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

I understand that information I provide regarding current and/or previous employers may be used and those employer(s) will be contacted, for the purpose of investigation my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

  • Review information provided by previous employers;

  • Have errors in the information corrected by previous employers and for those previous employers to resend the corrected information to the prospective employer; and

  • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

  • List your addresses of residency for the past 3 years.

    Current Address

    Previous Address

    Previous Address

    Previous Address

    If yes, please explain fully. Conviction of a crime is not an automatic bar to employment - all circumstances will be considered.

    Are there any reasons you may not be able to perform the functions of the job for which you have applied

    If yes, explain if you wish:

    All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state, and zip code.

    Applicants to drive a commercial motor vehicle* in intrastate and interstate commerce shall also provide an additional 7 years of information on those employers for whom the applicant operated such vehicle. (NOTE: list employers starting with the most recent. Add another sheet if necessary.)

    *Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles deigned to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quality requiring placarding.
    ** The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10, 001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

    Accident Record for Past 3 Years or More, if None, Leave Blank

    Traffic Convictions and Forfeitures for the past 3 Years (Other than Parking Violations) If None, Leave Blank

    List all driver licenses or permits held in the past 3 years If None, Leave Blank

    If the answer to either A or B is Yes, give details:


    I, (Print Name)

    Hereby Authorize

    To release and forward the information requested by section 4 of this document concerning my Alcohol and Controlled Substance Testing records within the previous 3 years from:

    Date of Employment Application
    Attention: Carla Tate
    Street: 1260 STATE FARM ROAD
    Address: ALEXANDRIA, AL 36250


    I hereby authorize you to release the following in formation to TRANTHAM SERVICES, INC. for the purpose of investigation as required by Section 391.23 of the Federal Motor Carrier Safety Regulations. You are released from any and all liability which may result from furnishing such information.

    This certifies that this application was completed by me, that all entries on it and information in it are true and complete to the best of my knowlege, and that I agree to all of the above.

    Sign Your Name Here:
    Trantham Services, Inc.
    Trantham Brokerage, Inc.
    Trantham Brokerage, Inc. is a licensed freight broker.
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