Driver Application Form

Name
Date of Birth
Must be 21 to apply
Home Address
Verification if you are eligible for work

Work History

Type of your experience
Address
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APPLICANT CERTIFICATION & AUTHORIZATION
By submitting this application, I certify that the information I have provided is true, complete, and correct to the best of my knowledge, and I understand that any false statement, omission, or misrepresentation may result in the rejection of my application or, if discovered after hire, immediate termination of employment. I voluntarily authorize Great Lakes Cargo, Inc. and its agents to collect, verify, store, and use the personal information I have provided — including my Social Security Number, date of birth, driver's license information, employment history, and any medical documentation (including but not limited to DOT medical examination results, Medical Examiner's Certificate, drug and alcohol testing records, and FMCSA Clearinghouse records) — for the purposes of processing my application, conducting pre-employment screening, verifying my qualifications, and complying with all applicable federal and state regulations, including the Federal Motor Carrier Safety Regulations (49 CFR Parts 40, 382, and 391). I further authorize Great Lakes Cargo, Inc. to obtain my motor vehicle record, criminal background report, employment verification, and consumer/investigative consumer reports in accordance with the Fair Credit Reporting Act (FCRA), and to share my information with prior employers, drug and alcohol testing facilities, medical examiners, and government agencies as necessary to complete the application process. I understand that my Social Security Number and medical records will be retained, transmitted, and protected in accordance with applicable privacy laws, and will only be disclosed as required by law or as necessary for the purposes stated above. I acknowledge that I have the right to review the information collected about me and to request a copy of any consumer report obtained in connection with this application. By checking the box below and submitting this application, I confirm that I have read, understood, and agree to the terms above, and that this electronic submission constitutes my legal signature.