Job Application

Have you paid the $29 application fee?
(If yes, toggle button to the right. If no, please pay application fee with the paypal link above.)
Yes, I have paid the application fee. I understand the $29 fee will be reimbursed, if I pass the screening. *

Name *

First

Last *

Last

Address *

Address

Address

Address

City

City

State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

State/Province

Zip/Postal

Zip/Postal

Have you lived at this address for more than 2 years? *

Yes

No

Email *

Phone *

Date of Birth *

Social Security Number (Format 123-12-1234) *

Drivers License Number *

Drivers License Issuing State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Drivers License Issue Date *

Drivers License Expiration Date *

Please describe your previous professional driving experience? *

If hired, are you interested in a part time or full time position?

Full Time

Part Time

Please describe your current availability? (include any ongoing commitments) *

If hired, when are you available to start? (Please input date) *

Have you had your driver’s license for longer than 3 years in the state you currently reside in? (if not please include previous state of residency) *

Do you currently have a commercial driver’s license endorsement? *

Yes

No

Have you been convicted of any moving violations and/or accidents in the last 5 years? *

Yes

No

Have you been convicted of any felonies or misdemeanor offenses involving drugs or alcohol in the last 5 years? *

Yes

No

Have you had continued insurance coverage in the last 5 years? *

Yes

No

Have you been denied insurance coverage in the last 5 years ? *

Yes

No

Please list all states and counties you have resided in the last 5 years? *

Review the following disclosure

All applicants must undergo a background check. Springfield Logistics LLC and its subsidiaries are committed to safety. As part of that commitment, Springfield Logistics LLC may obtain “consumer reports” (background checks) about you from a consumer reporting agency (“CRA”) in connection with your ability to enter into employment agreement with Springfield Logistics LLC. These reports may contain information regarding your criminal history, motor vehicle driving records (which may contain information about your physical, mental, or behavioral health maintained by a state government agency that has restricted your ability to drive legally), or other background checks.

Yes, I agree *

Acknowledgment & Authorization For Background Check

I acknowledge and agree that I have read and understand the Background Check Disclosure and further acknowledge that I have read, understand and agree with the statements contained in the additional disclosures. By my electronic signature, I hereby authorize Springfield Logistics LLC to obtain consumer reports about me from any CRA at any time after receipt of this authorization and throughout my employment. I agree that I am providing my electronic signature and that my electronic signature is binding just like a signature in ink. I agree and acknowledge.

Yes, I agree *

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