Driver Application – Hill Meat

Twitter
Facebook
Youtube

Sales Portal
Register

Home
Our Products
Our Quality
Our Story
Distribution
Drop Us a Swine
Careers
- Job Application
- Driver Application
Menu Menu

Home
Our Products
Our Quality
Our Story
Distribution
Drop Us a Swine
Careers
- Job Application
- Driver Application

Driver Application

Step 1 of 3 - Personal

0%

Personal Information
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
How Long at Current Address?*
Phone*
Email*
Available for Hire Date*
Date Format: MM slash DD slash YYYY
Date of Birth*
Date Format: MM slash DD slash YYYY
* Please provide your social security number by phone or in person.
Previous Three Years Recidency
Address & City*
State*
Zip*
# Years*
Address & City
State
Zip
# Years
Address & City
State
Zip
# Years
If you have additional residencies to add, please list them here
Personal References
List three persons for references, other than family members, who have knowledge of your safety habits.
Name*
Full Address*
Phone*
Name*
Full Address*
Phone*
Name*
Full Address*
Phone*
Education History
Select Highest Grade Completed*
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
- 6th Grade
- 7th Grade
- 8th Grade
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
- College - 1 Year
- College - 2 Year
- College - 3 Year
- College - 4+ Year
- Post-Graduate - 1 Year
- Post-Graduate - 2 Years
- Post-Graduate - 3 Years
- Post-Graduate - 4 Years

License Information
License Information
Section 383.21 FMCSR states "No person who operates a commercial motor vehicle shall at any time have more than one driver's license". I certify that I do not have more than one motor vehicle license, the information for which is listed below.
State*
License Number*
Type*
Expiration Date*
Date Format: MM slash DD slash YYYY
Driving Experience
Class of Equipment
Straight Truck
Type of Equipment
(Van, Tank, Flat, Etc...)
Dates (From - To)
Approx. No. Miles (Total)
Class of Equipment
Tractor and Semi-Trailer
Type of Equipment
(Van, Tank, Flat, Etc...)
Dates (From - To)
Approx. No. Miles (Total)
Class of Equipment
Tractor - Two Trailers
Type of Equipment
(Van, Tank, Flat, Etc...)
Dates (From - To)
Approx. No. Miles (Total)
Class of Equipment
Other
Type of Equipment
(Van, Tank, Flat, Etc...)
Dates (From - To)
Approx. No. Miles (Total)
Accident Record
For past 3 years or more (include more if needed in the box provided).
Dates
Nature of Accident
(Head-on, Rear-end, Upset, Etc...)
Number Fatalities/Inuries
Chemical Spills
- Yes
- No
Dates
Nature of Accident
(Head-on, Rear-end, Upset, Etc...)
Number Fatalities/Inuries
Chemical Spills
- Yes
- No
Dates
Nature of Accident
(Head-on, Rear-end, Upset, Etc...)
Number Fatalities/Inuries
Chemical Spills
- Yes
- No
Additional Accident Record Information
Traffic Convictions and Forfeitures
Include all for the past 3 years (other than parking violations).
Date Convicted (MM/YYYY)
Violation
State of Violation
Penalty
(forfeited bond, collateral and/or points)
Date Convicted (MM/YYYY)
Violation
State of Violation
Penalty
(forfeited bond, collateral and/or points)
Date Convicted (MM/YYYY)
Violation
State of Violation
Penalty
(forfeited bond, collateral and/or points)
Additional Traffic Convictions and Forfeitures (Optional)
Have you ever been denied a license, permit, or privilege to operate a motor vehicle?*
- Yes
- No
Please Explain*
Has any license, permit, or privilege ever been suspended or revoked?*
- Yes
- No
Please Explain*
DOT Physical Expiration Date*
Date Format: MM slash DD slash YYYY

Employment Record
Applicants that desire to drive in intrastate/interstate commerce must provide the following information on all employers during the previous three years. You must give the same information for all employers you have driven a commercial motor vehicle for the seven years prior to the initial three years (total of ten years employment record).
Current/Last Employer Name*
Current/Last Employer Phone*
Current/Last Employer Address*
Street Address City State ZIP Code
Position Held*
From*
Date Format: MM slash DD slash YYYY
To*
Date Format: MM slash DD slash YYYY
Salery*
Reasons for Leaving*
Any gaps in employment and/or unemployment must be explained. Include dates (MM/YYYY) and reason
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?*
- Yes
- No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 SFR Part 40?*
- Yes
- No
Second Last Employer Name
Second Last Employer Phone
Second Last Employer Address
Street Address City State ZIP Code
Position Held
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Salery
Reasons for Leaving
Any gaps in employment and/or unemployment must be explained. Include dates (MM/YYYY) and reason
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?
- Yes
- No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 SFR Part 40?
- Yes
- No
Third Last Employer Name
Third Last Employer Phone
Third Last Employer Address
Street Address City State ZIP Code
Position Held
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Salery
Reasons for Leaving
Any gaps in employment and/or unemployment must be explained. Include dates (MM/YYYY) and reason
Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer?
- Yes
- No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 SFR Part 40?
- Yes
- No
Additional Employers
If you have more than three previous employers to list, please do so in this box. Be sure to list the name, address, phone, position held, from when, to when, salary, reasons for leaving, and any gaps in employment, including dates and reason.

1503 N.W. 50th P.O. Box 1066
Pendleton, OR 97801

541-276-7621
800.929.7621
541.276.9253

Twitter
Facebook
Youtube

PRODUCTS

Bacon
Fresh Sausage
Ham
Smoked Sausage

ABOUT

Our Quality
Our Story
Distribution

Drop Us a Swine
Careers
Sales Portal
Site Map

© Hill Meat Company. All Rights Reserved