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TO BE READ AND SIGNED BY APPLICANT
For driver applicants of commercial motor vehicles that requires a Commercial Driver License (CDL) the applicant must disclose their controlled substance and alcohol status per the requirements of 49 CFR part 40.25(j).

As a prospective driver employee, you have the right to review information provided by previous employers. You have the right to have errors in the information corrected by the previous employer(s) and for that previous employer(s) to resend the corrected information to the prospective employer; the right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

Driver employees who have previous Department of Transportation regulated employment history in the preceding three (3) years, and wish to review previous employer provided investigative information, must submit a written request to the prospective employer, which may be done at any time, including when applying or as late as thirty (30) days after being employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five (5) business days of receiving the written request. If the prospective employer has not yet received the requested information from the previous employer(s), then the five (5) business day deadlines will begin when the prospective employer receives the requested safety performance history information. If the driver has not arranged to pick up or receive the requested records within thirty (30) days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived their request to review the records.
Certification
I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

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OSC
1111 Pierce Butler Route St. Paul, MN 55104
An Equal Opportunity, Affirmative Action and E-Verify Employer

Should you need reasonable accommodation when completing the application during the selection process, contact the Human Resources Department or other designated company representative. Information provided on this application will be kept confidential and only shared with those involved in the selection process.

 Please provide all information requested. Incomplete information may disqualify you from consideration.

What is your preferred contact method? Check all that apply. *
Are you 21 years or older? *
Are you legally authorized to work in the United States? *
As required by law, documents that prove identity and eligibility to work must be provided a time of hire.
Have you applied for employment with this company within the last 12 months? *
Have you ever worked for us before? *
Employment History
The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.
Work History *
Job 1
Job 2
Job 3
Were you subject to the Federal Motor Carrier Safety Regulations for any of your previous employers? *
Were you subject to the 49 CFR Part 40 controlled substance and alcohol testing during this period? *
Has your employment with any employer ever been involuntarily terminated? *
Accident Record
Have you had any accidents that have occurred within the last 3 years? *
Traffic Convictions and Forfeitures
Have you had any traffic convictions or forfeitures that have occurred within the last 3 years? *
Education
Highest Level of Education *
Driver's License Information
Please list all licenses held in the last 3 years.
State(s) held, license number, type, and expiration date
Have you ever had any driver license, permit or privilege to operate a motor vehicle denied, suspended, revoked, or canceled by any issuing state agency? *
Driving Experience
Please indicate which class of equipment you have used.
For driver applicants of commercial motor vehicles that requires a Commercial Driver License (CDL) the applicant must disclose their controlled substance and alcohol status per the requirements of 49 CFR part 40.25(j). *
Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years?
The following questions are to ensure EEOC compliance and are strictly voluntary. We maintain this data for EEOC inquiries and to assist in any discrimination investigations by the federal, state and local governments.
Voluntary Disability Status
In order to comply with applicable state laws, regulations, reporting obligations and contractual requirements under Minnesota Statutes Section 363A.36 and the City of Saint Paul Legislative Code Section 183.04, we invite you to voluntarily provide the below information if you wish to benefit under the provisions of these statutes. The below request is purely voluntary. You will not be subject to any adverse treatment based on your response or choice not to respond. Any information provided will be kept confidential, separate from personnel records, accessible only to limited authorized individuals and will be used only in accordance with the law.

Invitation to Self-Identify as a Veteran

This employer is a Government contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:

  • A "disabled veteran" is one of the following:
    • a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
    • a person who was discharged or released from active duty because of a service-connected disability.
  • A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service.
  • An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
  • An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below.

As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

Self-identification answer
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