Bulk DTI

Driver Pre-Qualification Application

Applicant Notice and Agreement


First name: Middle name: Last name:

Applying for:

NOTICE!

This Applicant Notice and Agreement must be carefully read and agreed to prior to filling out
an Independent Contractor application.

  1. An individual may only apply for the job position shown above at this time.
  2. Any individual who desires accommodation or assistance in making application employment at any time during the application process should inform the facility manager or other designated hiring authority (see Notice below).
  3. I understand that I will only be considered for the specific job position that I am applying for and that my application will only be considered active for thirty (30) days from the date of application.
  4. The purpose off the application form is to provide you with the opportunity to present your skills, experience, abilities, and other personal attributes that meet the qualification requirements for the job position being applied for. It is in your best interest to take your time and fully list the qualifications that you believe you have.
  5. All of the applicable inquiries on the application must be completed and the information that you provide must be accurate and truthful! If an inquiry is left blank, your application will not be considered. If you feel that the question asked or information sought is not applicable, put N/A for a response.
  6. Any false, inaccurate, or missing information will result in rejection of the application, or will result in termination of employment if such false or inaccurate information is discovered after the date of hire.
  7. I understand that a consumer report which may contain public record information will be requested from DAC services, Tulsa, Oklahoma. This report may include the following types of information: names and dates of previous employers, reason(s) for termination of employment, work experience, accidents, etc. I further understand that such report(s) may contain public record information concerning my driving record, worker’s compensation claims, credit, bankruptcy proceedings, etc. from federal, state and other agencies which maintain such records as well as information from DAC concerning previous driving record requests made by others from such state agencies, state provided driving records, and claims involving me in the files of insurance companies.
  8. Bulk Transportation uses an employment entrance medical examination (“physical”) in accordance with applicable laws. Any offer of Independent Contractor will be conditioned upon the applicant successfully passing this exam. The employment entrance medical examination will be administered after the conditional offer of employment, but before the performance of any job duties. If the applicant does not pass this exam, the conditional offer of employment will be withdrawn and any employment relationship shall cease. Additionally:
      a) In accordance with applicable laws, Controlled Substance and Alcohol testing is required of all applicants. Failure of such test(s), or the refusal to submit to such test(s), shall be considered a failure of the employment entrance medical examination.
      b) All medical data and information from the employment medical entrance examination shall be treated as a confidential medical record as required by applicable law.
  9. Certain job positions require the successful completion of skills test(s) such as the road test, typing test, mechanical proficiency test, or other demonstration of skills appropriate to the job position. Any offer of employment will be conditioned upon the successful completion of such test(s), if applicable. Any such skills test(s) required may be administered after the conditional offer of employment, but before the performance of any job duties. If the applicant does not pass the applicable skills test(s), the conditional offer of employment will be withdrawn and any employment relationship shall cease.
  10. I fully understand that if employed places me in a position requiring the operation of motor vehicles of any size or description owned, operated, or leased by Bulk Transportation, that my continuing employment may depend upon, among other factors, insurability with Bulk Transportation and that as an operator of such vehicles I may be subject to immediate termination if I become uninsurable due to traffic violations or accident involvement, irrespective of fault or cause, during the course of my employment.
  11. If employed, I agree to conform to the rules, regulations, and policies of Bulk Transportation and understand that, in accordance with applicable laws and regulations, my employment is “at will” and may be terminated with or without cause at any time, with or without notice, at the option of either myself or the company.

Legal name: Date (dd/mm/yyyy):



NOTICE!

The following is to be completed ONLY if you are declaring a disability and are requesting reasonable accomodation

INVITATION TO REQUEST REASONABLE ACCOMMODATION FOR APPLICANTS WITH A DISABILITY

Any applicant with a disability who needs reasonable accommodation in any step of the hiring process to help him or her demonstrate his or her qualifications to perform the duties of the job for which the individual is applying may so request such reasonable accommodation at any time during the application and/or skills demonstration process.

I hereby declare a disability under the Americans with Disabilities Act and request reasonable accommodation in the application and/or skills demonstration process.

Legal name: Date (mm/dd/yyyy):