Owner Operator Application Form – Chegar Corp.

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Driver Application Form

📌 If you wish to submit an application for a Company Driver position, kindly proceed to the Company Driver Application Form by clicking the button below.

Company Driver Application Form

📌 Please carefully go through the form step by step and select the “Submit” button located at the end of the document.

Please enable JavaScript in your browser to complete this form.

- Step 1 of 5

Driver Application Form

Do you have a truck or are you interested in driving a company truck? *

Vehicle Owner
Company Driver

Company:

Full Company Info

Full Company Info II

🔵 Personal Information:

Name *

First

Middle

Last

Address *

Address Line 1

City

State

Zip Code

Layout

Date of birth *

Email *

SSN# *

Phone *

🔵 Disclaimer:

By submitting your mobile number, you consent to receive SMS notifications containing job offers from CHEGAR CORP.. These messages may include a link to our website for application details. Standard messaging rates may apply, and you can opt-out anytime by replying "STOP" to the received messages. Your mobile number will be kept confidential and will not be shared with third parties. For questions, contact us at (708) 328-8333. *

I agree

CHEGAR CORP. (Privacy Policy)

I have reviewed the privacy policy of the company *

I have reviewed the privacy policy of the company

🔵 Previous Addresses:

📌 You can skip it if you haven't changed your address in the previous 3 years.

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Address 2

Address Line 1

City

State

Zip Code

Address 3

Address Line 1

City

State

Zip Code

🔵 DRIVER LICENSES

DRIVER LICENSE 1

DRIVER LICENSE 1

State *

License No. *

Type *

Expiration date *

DRIVER LICENSE 2

DRIVER LICENSE 2

State

License No.

Type

Expiration date

🔵 DRIVING EXPERIENCE

STRAIGHT TRUCK

DRIVER LICENSE 2 (copy)

Type of equipment

(VAN, TANK, FLAT, ETC)

Date from

Date to

No. of miles

Approx. of total miles

TRACTOR & SEMI-TRAILER

TRACTOR & SEMI-TRAILER

Type of equipment

(VAN, TANK, FLAT, ETC)

Date from

Date to

No. of miles

Approx. of total miles

🔵 ACCIDENT RECORD FOR PAST 3 YEARS

ACCIDENT 1

ACCIDENT 1

Date

Nature of accident

(HEAD-ON, REAR-END, UPSET, ETC)

Fatalities

Injuries

ACCIDENT 2

ACCIDENT 2

Date

Nature of accident

(HEAD-ON, REAR-END, UPSET, ETC)

Fatalities

Injuries

ACCIDENT 3

ACCIDENT 3

Date

Nature of accident

(HEAD-ON, REAR-END, UPSET, ETC)

Fatalities

Injuries

🔵 TRAFFIC CONVICTIONS AND FORFEITURES FOR PAST 3 YEARS

📌 OTHER THAN PARKING VIOLATIONS

CONVICTIONS AND FORFEITURES 1

CONVICTIONS AND FORFEITURES 1

Location

Date

Charge

Penalty

CONVICTIONS AND FORFEITURES 2

CONVICTIONS AND FORFEITURES 2

Location

Date

Charge

Penalty

Have you ever been convicted of a Felony, DUI or DWI? *

YES
NO

If yes, please explain:

Has any license, permit or privilege ever been suspended or revoked? *

YES
NO

🔵 PAST EMPLOY MENT RECORD

📌 LIST ALL PAST EMPLOYMENT FOR THE LAST THREE YEARS AND ALL DOT REGULATED PAST EMPLOYERS FOR THE PAST 10 YEARS

🔷 How many previous job entries are required?

Selected Value: 0

🔷 LAST EMPLOYER

Last Employer Name

Address

Address Line 1

City

State

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Phone Number

Fax Number

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Position Held

From

To

Reason for Leaving

Where you subject to U.S. DOT drug & alcohol testing?

YES
NO

Was this employer regulated by U.S. DOT?

YES
NO

🔷 SECOND LAST EMPLOYER

Second Last Employer Name

Address

Address Line 1

City

State

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Phone Number

Fax Number

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Position Held

From

To

Reason for Leaving

Where you subject to U.S. DOT drug & alcohol testing?

YES
NO

Was this employer regulated by U.S. DOT?

YES
NO

🔷 THIRD LAST EMPLOYER

Third Last Employer Name

Address

Address Line 1

City

State

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Phone Number

Fax Number

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Position Held

From

To

Reason for Leaving

Where you subject to U.S. DOT drug & alcohol testing?

YES
NO

Was this employer regulated by U.S. DOT?

YES
NO

🔷 FOURTH LAST EMPLOYER

Fourth Last Employer Name

Address

Address Line 1

City

State

Layout IV

Phone Number

Fax Number

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Position Held

From

To

Reason for Leaving

Where you subject to U.S. DOT drug & alcohol testing?

YES
NO

Was this employer regulated by U.S. DOT?

YES
NO

🔷 FIFTH LAST EMPLOYER

Fifth Last Employer Name

Address

Address Line 1

City

State

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Phone Number

Fax Number

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Position Held

From

To

Reason for Leaving

Where you subject to U.S. DOT drug & alcohol testing?

YES
NO

Was this employer regulated by U.S. DOT?

YES
NO

🔵 EMPLOYMENT HISTORY

I understand that I must provide my complete employment history for the past 3 years, and all CDL required employment for the 7 years preceding that. In addition, during this time, I was convicted of any criminal act involving the use of a commercial motor vehicle or while driving a commercial motor vehicle: *

YES, I WAS CONVICTED
NO, I WAS NOT CONVICTED

If you answered yes to the above questions, attach a statement of explanation and provide proof of return to duty process.

Click or drag a file to this area to upload.

Any gaps in employment longer than 1 month are explained as follows: *

🔵 DOCUMENTS UPLOAD

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Driving license *

Click or drag a file to this area to upload.

Medical card *

Click or drag a file to this area to upload.

Truck registration

Click or drag a file to this area to upload.

Truck annual inspection

Click or drag a file to this area to upload.

Physical damage insurance

Click or drag a file to this area to upload.

Non trucking liability insurance

Click or drag a file to this area to upload.

🔵 AUTHORIZATION

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interviews may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. I understand information I provide regarding current and/or previous employers may be used, and those employers will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23 (d) and (e). I understand that I have the right to:

Review information provided by the previous employers;
Have errors in the information corrected by previous employers and those previous employers to resend the corrected information to the prospective employer;
Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

This certifies 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. I certify that I have read, understand, and agree to abide by the condition of this consent and release form. I authorize Chegar Corp. (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.

DISCLOSURE CHEGAR CORP. or its affiliates (“the Company”) may request one or more consumer reports or investigative consumer reports about you for employment purposes. For explanation purposes, these reports may include information on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living which may be used as a factor in making an employment-related decision about you. Such information may include, for example, credit information, criminal history reports, driving records, or personal interviews with your prior employers, neighbors, friends, or associates, or with others who may have knowledge concerning any such items of information. The Company will obtain the consumer reports and investigative consume reports from Safety Holdings, Inc. dba SambaSafety. SambaSafety can be contacted by mail at 8814 Horizon Blvd #100, Albuquerque, NM 87113; or phone: (888) 947-2622; or website: www.sambasafety.com.

Please check this box to have a copy of your report emailed directly to your email: *

I agree

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Date *

Signature *

Initials *

Copyright © 2024 Chegar Corp.

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