APPLY TO BECOME A BTI TRUCK DRIVER

We are always looking for qualified company drivers and independent contractors to become part of our professional team. We have national truck driving jobs available in 48 states including Ohio, Indiana, Illinois, and Kentucky. If you are interested in one of our many truck driving jobs, please fill out the information below and submit your application.

* denotes a required field.

Applying For: *	Company Driver Independent Contractor
First Name: *
M.I.:
Last Name: *
Current Address:: *
City: *
State: *
Zip Code: *
How long at your current address: * ENTER YEARS AT THIS ADDRESS
Phone Number: * PHONE NUMBER - PLEASE USE NUMBERS ONLY
Email Address: *
Preferred way to contact you: * What is the best way for us to contact you
Are you a US Citizen?: * Are you legally authorized to work in this country?
Date of Birth: *
Social Security Number: *
How were you referred to BTI:

EDUCATIONAL BACKGROUND

Select highest grade completed:
Last school attended:

MILITARY BACKGROUND

Branch:
Date of enlistment:
Date of discharge:
Reason for discharge:
Honorable discharge:

LICENSE INFORMATION

LIST ALL DRIVERS LICENSES YOU HAVE HELD IN THE PAST 5 YEARS

State: *
Type of license: *
License number: *
State:
Type of license:
License number:
State:
Type of license:
License number:
State:
Type of license:
License number:
TRACTOR/TRAILER INFORMATION MUST BE COMPLETED IF AN OWNER OPERATOR
Tractor year:
Tractor make:
Tractor model:
Trailer year:
Trailer make:
Trailer model:
TRAFFIC CONVICTIONS / SUSPENSIONS LIST ALL CAR,TRUCK,MOVING TRAFFIC CONVICTIONS FOR THE PAST 5 YEARS. If none type(none)
Violation date:
Violation State:
Charge:
Mph over:
Penalty:
Violation date:
Violation State:
Charge:
Mph over:
Penalty:
Violation date:
Violation State:
Charge:
Mph over:
Penalty:
ACCIDENT RECORD PLEASE LIST ALL ACCIDENTS WITH TRUCK, CAR ETC FOR THE PAST(5)years, including preventable and non-preventable (if none type none)
Accident Date:
Type of vehicle:
Nature of accident (Head on, etc):
Fatalities:
Injuries:
Amount of Damage:
Accident Date:
Type of vehicle:
Nature of accident (Head on, etc):
Fatalities:
Injuries:
Amount of Damage:
Accident Date:
Type of vehicle:
Nature of accident (Head on, etc):
Fatalities:
Injuries:
Amount of Damage:
NATURE AND EXTENT OF EXPERIENCE
Tractor with flatbed or specialized
YES/NO: *
From:
To:
# States:
Miles:
TRACTOR WITH VAN OR REFER
YES/NO:
From:
To:
# States:
Miles:
TRACTOR WITH TANK
YES/NO:
From:
To:
# States:
Miles:
***HAVE ANY LICENSE, PERMIT OR PRIVILEGES BEEN SUPENDED
SELECT: *
*** HAVE YOU EVER BEEN ARRESTED AND /OR CONVICTED FOR DRIVING UNDER INFLUENCE OF ALCOHOL OR HAVE A CURRENT CHARGE PENDING?
SELECT: *
*** HAVE YOU EVER BEEN CONVICTED FOR POSSESSION, SALE, OR USE OF A NARCOTIC DRUG, AMPHETAMINES, OR A DERIVATIVE THEREOF, OR HAVE A CURRENT CHARGE PENDING?
SELECT: *
**HAVE YOU EVER BEEN CONVICTED OF A FELONY AND/OR MISDEMEANOR CHARGE
SELECT: *
** HAVE YOU EVER BEEN REFUSED A SECURITY BOND
SELECT: *
IF YOU ANSWERED YES TO ANY OF THE ABOVE QUETIONS, PLEASE EXPLAIN(INCLUDE DATE OF OCCURENCE):
YES/NO: *

EMPLOYMENT HISTORY

* PRESENT OR LAST EMPLOYER(PLEASE INCLUDE AT LEAST 10 YEARS OF JOB HISTORY)
NAME: *
ADDRESS: *
CITY: *
STATE: *
ZIP CODE: *
PHONE NUMBER: * PHONE NUMBER PLEASE ENTER NUMBERS ONLY
POSITION: *
FROM: *
To:
REASON FOR LEAVING: *
COMMODITY HAULED: *
FORMER EMPLOYER #2
NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE NUMBER:
FROM:	In mm/dd/yyyy format
To:	In mm/dd/yyyy format
REASON FOR LEAVING:
COMMODITY HAULED:
FORMER EMPLOYER #3
NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE NUMBER:
FROM:
To:
REASON FOR LEAVING:
COMMODITY HAULED:
FORMER EMPLOYER #4
NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE NUMBER:
FROM:
TO:
REASON FOR LEAVING:
COMMODITY HAULED:
FORMER EMPLOYER #5
NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE NUMBER:
FROM:
TO:
REASON FOR LEAVING:
COMMODITY HAULED:

COMPLETE THE APPLICATION

I HEREBY ATTEST THAT THE INFORMATION PROVIDED IS TRUE AND ACCURATE
SIGNED:
I AUTHORIZE BTI SPECIAL COMMODITIES TO INVESTIGATE THE INFORMATION THAT I HAVE PROVIDED AND REQUEST DRIVER INFORMATION RECORDS FROM HIRERIGHT OR ANYOTHER EMPLOYMENT VERIFICATION SERVICE.
THIS MAY INCLUDE BUT NOT BE LIMITED TO THE FOLLOWING INFORMATION:
NAMES OF PREVIOUS EMPLOYERS, DATES OF EMPLOYMENT,REASON FOR TERMINATION OF EMPLOYMENT, WORK EXPERIENCE, ACCIDENTS, AND ANY OTHER INFORMATION REQUIRED BY 49 CFR 391.23 OR FUTURE UPDATES
YES OR NO: *
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