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Thank you for your interest in a Contractor/Owner Operator driving opportunity with Central Transport. We can offer excellent revenue potential as well as premium home time in either a local or road contractor position within our growing network of service centers. To get started, fill out completely and submit the Contractor Online Data Sheet below. Within 24 hours of submitting the online Data Sheet you will be contacted by a field contractor Relations Manager to discuss the opportunities available in your area.

Driver Data Sheet

Work Interest
Local P&D Contractor:
Linehaul / Over-the-road  Contractor:
How Were You Refered to Our Company?:

Personal Information
First Name: Current Address:
Middle Name: City:
Last Name: State:
Phone Number: ( ) - Email:  
Cell Number: ( )   -
Have you ever been convicted of a felony?:
If yes, when and description?:

Drivers License Information Driving Experience
Date of Birth : / / How many years of tractor / trailer experience?:
State: How many years of straight truck experience?:
License Number: Number of traffic violations in the past 5 years:
Expiration Date: / / Number of accidents in the past 5 years:
Class: Has your license ever been suspended,
revoked, or restricted?:
Endorsements: If yes, when?:

Tractor Information (if applicable)
Tractor year: Daycab or Sleeper?
Tractor Make: Are you interested in a Lease Purchase Program?

Employment History
Carrier/Employer 1: Address:
From: City/State/Zip:
To: Phone Number: ( )   -
Position: Contact Name?:
Earnings: May We
Contact?:
Reason For Leaving?:
Carrier/Employer 2: Address:
From: City/State/Zip:
To: Phone Number: ( )   -
Position: Contact Name?:
Earnings: May We
Contact?:
Reason For Leaving?:

This form is a preliminary step in the Company's contracting process. If a mutual interest is determined, further information will be required to continue processing.

IMPORTANT - READ CAREFULLY BEFORE SUBMITTING YOUR ONLINE DATA SHEET

By clicking the "submit" button I hereby authorize company authorized individuals to investigate and compile history of my former employment, and or customers, together with any and all information concerning my business practices, ability, personal character, credit, arrest record, etc. I hereby release this company and its authorized individuals from any and all liability for damages whatsoever that may result to me upon completion of above defined investigation. Further, I hereby authorize the present and past customers/employers listed herein to furnish my previous service/employment record with them, with reasons for termination of services, or separation of employment and any and all information which said company may have concerning me or my business to the company's investigation agency. I also release present and past customers and employers listed herein, and their authorized individuals from any and all liability for damages whatsoever as a result of furnishing my past service records, employment records, including alcohol and controlled substances information per Department of Transportation Regulation 49 CFR 40.25. Further, I authorize any local, county, state, or federal law enforcement agency to furnish any and all information regarding any arrest, conviction, or information listed under my name that might be on file to the company's investigative agencies. I hereby release said law enforcement agency from any and all liability for damages whatsoever which may result for furnishing any information concerning my business or me. By completion of this data sheet I confirm that I am representing myself as an Independent Contractor and understand that the investigative report is being created in order to fulfill the DOT requirements as to background investigations. I acknowledge I am not applying for, nor am I being offered employee status by this data sheet. I have read and understand the above.

 



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6/19/2013 - 8:52 PM
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6/19/2013 - 8:52 PM
6/19/2013 - 8:52 PM