*Required Fields

Driver Application
First Name:*
Initial: Last Name:*
Address 1:
Address 2:
City:
State: Zip:
Date of Birth:
Social Security Number: - -
Phone:
- - Cell: - -
Number to contact you on the road:
If the number is not phone or cell, please provide a Contact Number
Contact Number: - -
Additional information on how to contact you while on the road:
Applicant Category:
License State: Commercial License Number:
Do you have Container experience:
Container Experience Information (Include number of years experience):
Number of moving violations in last 3 years:
Accidents: # Preventable:
Any history of DUI, DWI or reckless operation:
Any license suspension in the past 3 years:
If yes to DUI or Suspension, please explain:
Ever been convicted of a felony:
If yes to felony, please explain:

Previous Driving Experience 3 Years Req.; Start w/ current emp.
Start Date:
End Date:
Employer:
Address 1:
Address 2:
City:
State: Zip:
Phone:
- - Supervisor:
Duties:
Title:
Reason For Leaving:

Start Date:
End Date:
Employer:
Address 1:
Address 2:
City:
State: Zip:
Phone:
- - Supervisor:
Duties:
Title:
Reason For Leaving:

Start Date:
End Date:
Employer:
Address 1:
Address 2:
City:
State: Zip:
Phone:
- - Supervisor:
Duties:
Title:
Reason For Leaving:

Start Date:
End Date:
Employer:
Address 1:
Address 2:
City:
State: Zip:
Phone:
- - Supervisor:
Duties:
Title:
Reason For Leaving:

Start Date:
End Date:
Employer:
Address 1:
Address 2:
City:
State: Zip:
Phone:
- - Supervisor:
Duties:
Title:
Reason For Leaving:

Comments or Questions:
Can current employer be contacted?:
Can previous employer be contacted?:
By submitting this application, which is electronically transmitted without signature, I certify that I have personally completed this application and all of the information is true and correct. I authorize Horizon Freight System to conduct a thorough background investigation in accordance with the state and federal law and authorize my previous employers to release any information requested by Kaplan Trucking and hold them harmless of all liability from the release of said information. Also, in accordance with the provisions of 49 CFR Part 382.405 and 382.413, I hereby authorize and require my previous and/or current employers specifically listed by me to release the results (including any refusal to test) of all drug and alcohol tests.
I have read, understand and agree to the submission release: