Hauser Investments, Inc. | Online Job Application

CONTACT INFORMATION
Date:
 Month:*  Day:*  Year:*
First Name:* Last Name:* Middle Name:
Address Line 1: Address Line 2: City:
State: Zip/Postal Code: Home Phone:
Cell Phone: Other: Email Address:*
Date of Birth:
Month: Date: Year: State: Country:
* Required
EMERGENCY CONTACT
Emergency Contact - Part 1
Contact Name: Relation to Candidate: Contact Telephone:
Address Line 1: Address Line 2: Zip/Postal Code:
State: City:    Country:
Emergency Contact - Part 2
Contact Name: Relation to Candidate: Contact Telephone:
Address Line 1: Address Line 2: Zip/Postal Code:
State: City:    Country:
DRIVER INFORMATION
Linehaul Contractor Driver Full-Time Part-Time
Positions Applied for: Salary Desired: When available to begin work?
Are you eligible to lawfully work in the United States? Yes No
Are you at least 18 years of age? Yes No
Are you presently employed or under contract? Yes No
Do you have a former name? Yes No
If yes please list former name:
First Name: Middle Name: Last Name
Have you ever been discharged from a place of employment or a contract? Yes No
If yes explain:
May we contact your current employers? Yes No
Note:
Federal Motor Carrier Safety Regulations require Fedex Ground / Fedex Home Delivery to make inquires to each of your past employers.
Do you have a current Department of Transportation (DOT) physical? Yes No
Last DOT Physical Information:
Issued Date: Expires Date: Did you qualify? Yes No
Health Care Professional Information:
Physician Name:
Medical Facility Address:
Address Line 1: Address Line 2: City
State: Zip Code: Country:
DRIVER LICENSE INFORMATION
Driver License: State:
Date Issued: Date Expires:
ENDORSEMENTS
Class A Class B Class C
Hazmat Tanker Double/Triple Trailer
Restrictions:
RESIDENTIAL ADDRESS HISTORY
Please enter all addresses where you have lived in the last three (3) years, including your present address.
Residential Address History - Part 1
From Date: To Date:
Address Line 1: Address Line 2: City:
State: Zip Code: Country:
Residential Address History - Part 2
From Date: To Date:
Address Line 1: Address Line 2: City:
State: Zip Code: Country:
Residential Address History - Part 3
From Date: To Date:
Address Line 1: Address Line 2: City:
State: Zip Code: Country:
Residential Address History - Part 4
From Date: To Date:
Address Line 1: Address Line 2: City:
State: Zip Code: Country:
DRIVING WORK HISTORY/EXPERIENCE
If you do not have driving work history or experience please answer "NO" on this page and enter your work history on "Non-Driving Employment History".
Do you have driving work history and experience in a Cargo Van, Commercial Truck,
other Commercial Vehicle, or CDL Tractor Trailer?
Yes No
If Yes please enter this information below and entering necessary details.
Driving Work History/Experience - Part 1
Vehicle Type: Fuel Type:
Trailer Type: Trailer Type if Other:
Start: End:
Month: Date: Year:
Month: Date: Year:
Are you an independent Contractor/Driver: Yes No
Employer (List employer name from payroll statements):
Is this your current Employer: Yes No
Is the motor carrier name same as employer? Yes No
If "NO" please Enter Motor Carrier Name!
Note:
If you were employed by a Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.
Motor Carrier Name:
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Driving Work History/Experience - Part 2
Vehicle Type: Fuel Type:
Trailer Type: Trailer Type if Other:
Start: End:
Month: Date: Year:
Month: Date: Year:
Are you an independent Contractor/Driver: Yes No
Employer (List employer name from payroll statements):
Is this your current Employer: Yes No
Is the motor carrier name same as employer? Yes No
If "NO" please Enter Motor Carrier Name!
Note:

If you were employed by a Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.
Motor Carrier Name:
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Driving Work History/Experience - Part 3
Vehicle Type: Fuel Type:
Trailer Type: Trailer Type if Other:
Start: End:
Month: Date: Year:
Month: Date: Year:
Are you an independent Contractor/Driver: Yes No
Employer (List employer name from payroll statements):
Is this your current Employer: Yes No
Is the motor carrier name same as employer? Yes No
If "NO" please Enter Motor Carrier Name!
Note:

If you were employed by a Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.
Motor Carrier Name:
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Driving Work History/Experience - Part 4
Vehicle Type: Fuel Type:
Trailer Type: Trailer Type if Other:
Start: End:
Month: Date: Year:
Month: Date: Year:
Are you an independent Contractor/Driver: Yes No
Employer (List employer name from payroll statements):
Is this your current Employer: Yes No
Is the motor carrier name same as employer? Yes No
If "NO" please Enter Motor Carrier Name!
Note:

If you were employed by a Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.
Motor Carrier Name:
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Driving Work History/Experience - Part 5
Vehicle Type: Fuel Type:
Trailer Type: Trailer Type if Other:
Start: End:
Month: Date: Year:
Month: Date: Year:
Are you an independent Contractor/Driver: Yes No
Employer (List employer name from payroll statements):
Is this your current Employer: Yes No
Is the motor carrier name same as employer? Yes No
If "NO" please Enter Motor Carrier Name!
Note:

If you were employed by a Agency (ie KellyServices) and drove for a Motor Carrier (ie FedexGround) then list the temporary Agency as the employer and enter the name of the motor carrier in the space provided.
Motor Carrier Name:
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
NON-DRIVING EMPLOYMENT HISTORY AND UNEMPLOYMENT HISTORY
Please list the period of unemployment in this section. Enter Driving history and Experience in previous section. If Unemployed please fill out two sections of this page.
Do you have Non-Driving employment history? Yes No
If Yes please enter this information below and entering necessary details.

List Present and ALL previous Non-Driving employment in the past 10 years with NO gaps and enter any necessary details.

Start with present and work back.

To indicate period of unemployment please enter dates of unemployment and in section of Current Status select unemployed and explain details in the area after that.
Non-Driving Employment History and Unemployment History - Part 1
Start: End:
Month: Date: Year:
Month: Date: Year:
Employer: (List employer name from payroll statements)
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Non-Driving Employment History and Unemployment History - Part 2
Start: End:
Month: Date: Year:
Month: Date: Year:
Employer: (List employer name from payroll statements)
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Non-Driving Employment History and Unemployment History - Part 3
Start: End:
Month: Date: Year:
Month: Date: Year:
Employer: (List employer name from payroll statements)
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Non-Driving Employment History and Unemployment History - Part 4
Start: End:
Month: Date: Year:
Month: Date: Year:
Employer (List employer name from payroll statements):
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
Non-Driving Employment History and Unemployment History - Part 5
Start: End:
Month: Date: Year:
Month: Date: Year:
Employer (List employer name from payroll statements):
Address: City: State:
Zip Code: Country: Telephone:
Ending Job Title: Ending Pay Rate: Frequency:
Business Type: Supervisor Name: # of People Supervised:
Current Status:
Explain:
SCHOOLING AND TRUCK DRIVER TRAINING DETAILS
SCHOOLING AND TRUCK DRIVER TRAINING DETAILS - Part 1
School Type: Country: No Years Attend:
Started: Finished:
Month: Year:
Month: Year:
Graduated? Yes No
School: City: State:
Zip Code: Degree: Major:
Contact Name: Contact Telephone: Contact Email Address:
SCHOOLING AND TRUCK DRIVER TRAINING DETAILS - Part 2
School Type: Country: No Years Attend:
Started: Finished:
Month: Year:
Month: Year:
Graduated? Yes No
School: City: State:
Zip Code: Degree: Major:
Contact Name: Contact Telephone: Contact Email Address:
LEGAL HISTORY
Please enter the following information regarding your Legal History.
Have you ever been convicted or plead guilty to a felony under your present or any other name? Yes No
Have you ever been convicted or plead guilty to a misdemeanor under your present or any other name? Yes No
Do you have any criminal matters pending under your present or any other name? Yes No
Comments:
Driving Violations / Citations
Have you been convicted of or forfeited bond for violation of motor vehicle laws or ordinances other than parking during the past (3) years or do you have any pending matters relating to motor vechicle laws or ordinances? Yes No
If Yes list those violations below and enter any necessary details.
Part 1
Date of Violation:
Nature of Violation (If speeding, indicate rate of speed and speed limit):
Vechicle Type: Country: State:
Penalty (Indicate fine and length of suspension):
Points:
Part 2
Date of Violation:
Nature of Violation (If speeding, indicate rate of speed and speed limit):
Vechicle Type: Country: State:
Penalty (Indicate fine and length of suspension):
Points:
Part 3
Date of Violation:
Nature of Violation (If speeding, indicate rate of speed and speed limit):
Vechicle Type: Country: State:
Penalty (Indicate fine and length of suspension):
Points:
Part 4
Date of Violation:
>Nature of Violation (If speeding, indicate rate of speed and speed limit):
Vechicle Type: Country: State:
Penalty (Indicate fine and length of suspension):
Points:
Accident History
Have you been involved in Any motor vehicle accident in the past 3 years? Yes No
If Yes list All accidents you have had while operating ANY TYPE of motor vehicle during the past (3) years below and enter all necessary details.
Part 1
Date of Accident:
Nature of Accident:
Describe Extent of damage / injuries including monetary value if applicable:
Number of Deaths: Number of injuries: Vehicle Type:
At Fault? Yes No
Part 2
Date of Accident:
Nature of Accident:
>Describe Extent of damage / injuries including monetary value if applicable:
Number of Deaths: Number of injuries: Vehicle Type:
At Fault? Yes No
Part 3
Date of Accident:
Nature of Accident:
Describe Extent of damage / injuries including monetary value if applicable:
Number of Deaths: Number of injuries: Vehicle Type:
At Fault? Yes No
FedEx Contacts and Relatives
Do you know anyone employed or contracted by FedEx Ground or an affiliate company? Yes No
If so please enter the person(s) information below and entering any necessary details.
Part - 1
First Name: Last Name: Suffix:
Position: Location/Company: Relation:
Part - 2
First Name: Last Name: Suffix:
Position: Location/Company: Relation:
Part - 3
First Name: Last Name: Suffix:
Position: Location/Company: Relation:
Part - 4
First Name: Last Name: Suffix:
Position: Location/Company: Relation:
Military Service
Do you have any Military Service: Yes No
Military Service Start and End Dates:
Start Date: End Date:
Military Branch: Other: Primary Specialty:
Rank at Discharge: Military Separation Status:
How did you find out about us?
Select the Referral Source that best describes how you found out about the company.

- If the Referral Source is other, provide the details in Other Referral Source.
- If the Referral Source is Current Contractor, provide the details in Referring Fedex Contractor information selection.
Referral Source:
Other Referral Source:
Referral Name: