B & G Supply CO., INC. Online Application
Position * Driver Mechanic
Position Applying For
 
Contact Information
First Name *
Middle Name  
Last Name *
Email Address *
Phone Number *
Cell Phone  
Date of Birth *
 
Current Address
Address *
City *
State *
Zip Code *
 
Previous Address
Address *
City *
State *
Zip Code *
 
Education
Highest Grade Completed *
College  
Last School Attended *
 
Employment
Have you worked For Us Before * Yes No
Date Started  
Date Ended  
Position  
Rate of Pay  
Reason For Leaving  
Name of relatives who work for us  
 
List current and past employment starting with the most recent
 
Employment #1 (If none, please type, NONE, for company name and reason for leaving.)
Company *
Address  
City, State Zip  
Contact Person  
Phone Number  
Date Employment Started  
Date Employment Ended  
Position Held  
Salary / Wage  
Reason for leaving *
 
Employment #2 (If none, please type, NONE, for company name and reason for leaving.)
Company *
Address  
City, State Zip  
Contact Person  
Phone Number  
Date Employment Started  
Date Employment Ended  
Position Held  
Salary / Wage  
Reason For Leaving *
 
Employment #3 (If none, please type, NONE, for company name and reason for leaving.)
Company *
Address  
City, State Zip  
Contact Person  
Phone Number  
Date Employment Started  
Date Employment Ended  
Position Held  
Salary / Wage  
Reason For Leaving *
 
Driving Experience
How many years of experience do you have? *
CDL Class A * Yes No
Hazmat Endorsement * Yes No
 
Please choose all that apply
Equipment Experience   Straight Truck
Tractor and Semi-Trailer
Tractor - Two Trailers
 
List any Drivers Licenses held in the past 5 years.
State *
License Number *
Expiration *
 
State  
License Number  
Expiration  
 
State  
License Number  
Expiration  
 
Background
License ever been suspended or revoked * Yes No
List any moving violation in past 3 years  
List any accidents in past 5 years  
List any reckless or careless driving tickets you have ever had  
Have you even been convicted of a Felony? * Yes No
If yes please fully explain  
Have you ever been bonded * Yes No
Name of bonding company  
 
Additional Comments
Comments or Questions  
Terms and Conditions
Applicants are considered without regard to race, color, age, religion, sex, marital status, national origin, citizenship, handicap, disability or any other status protected under federal or state law. It is agreed and understood that this application for employment is subject to approval and acceptance of corporate headquarters personnel. I understand and acknowledge that such acceptance and approval is necessary before I will be employed by the company. It is agreed and understood that the information in this application will be used and that prior employers will be contacted for purposes of investigation as required by 391.23 of the Motor Carrier Safety Regulations. It is agreed and understood that any misrepresentations of information given above shall be considered an act of dishonesty. It is agreed and understood that the employer or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information. It is agreed and understood that the employer or his agents may obtain a consumer report which may contain public record information from DAC Services, Tulsa, Oklahoma. This report may include the following types of information: names and dates of previous employers, reason for termination of employment, work experience, accidents, etc. I further understand that such report may contain public record information concerning my driving record, workers' compensation claims, credit, bankruptcy proceedings, criminal records, 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, and state provided driving records. As such, I authorize, without reservation, any party or agency contacted by DAC or the employer to furnish the above-mentioned information. It is also agreed and understood that under the Fair Credit Report Act, Public Law 91-508, I have been told that this investigation may include an Investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. It is agreed and understood that, in connection with my application for employment (including contract for services), the employer or his agents may I agree to furnish such additional information and complete such examinations as may be required to complete my employment file. It is agreed and understood that this application for employment in no way obligates the employer to employ me; and it is understood that if hired, I will be on a 90 day probationary period during which I may be discharged without recourse. It is agreed and understood that I understand that this application is not an employment contract and that if hired, my employment and compensation can be terminated, with or without cause, at any time at the option of either the company or myself. I certify that my answers to questions pertaining to physical history are correct and that if any answer is found to be false or inaccurate, my future employment is subject to termination without notice. This certifies 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.
You must agree to the terms and conditions. * I agree
 
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