Document

Thank you for your interest in our offer.

Please complete our online operator work history. Incomplete information will delay the processing of your work history or prevent it from being submitted. This process will take 20-30 minutes, so please make sure you have time to complete this before you get started. If you stop mid-way through the application and come back later, make sure to enter at least your name, dob, ssn on the blank app and then click the "Partial Application" on the "Saved Application Selection" popup and you can pick up where you left off. Please make sure you are entering your name exactly as it appears on your CDL.

To fill out this form, you will need to know the following:

Social Security Number
Home address history for the past 3 years
Current drivers license number and drivers license history for the past 3 years
Employment history up to 10 years
History of traffic accidents, violations, and / or convictions from the last 5 years (including DUI or reckless driving convictions and license suspensions)
Military history (if applicable)

Required entry fields are followed by *, meaning you must provide the requested information to continue. If you encounter any errors during this process and cannot continue, please contact us at 800-000-0000.

Requirements:

To qualify with Carrier, you must meet the following criteria:

Must be at least 23 years of age
Class A (or Class B for Expedited) CDL with HazMat (H) or combination (X) endorsement
No more than two at-fault accidents and two motor vehicle violations within the previous 36 months, or no more than one at-fault accident and three motor vehicle violations during the previous 36 months. No involvement in a preventable DOT recordable accident in the past 12 months
Operators must have one year (six months for Expedited) of verifiable over-the-road driving within the past three years or two years verifiable experience in the last 5 years, with a Class A (or Class B for Expedited) CDL using the type of equipment similar to what you will be operating at Carrier
No felony convictions within the past 7 years. All other felony and misdemeanor charges are reviewed on a case-by-case basis
No positive drug or alcohol test including refusals and pre-employment results
No suspensions of more than 30 days for moving violations in the last 36 months
No more than one serious violation as defined on Table 2 of section 383.51 of the FMCSR handbook within the previous 36 months prior to qualification
o railroad-highway grade crossing offenses as defined on Table 3 of section 383.51 of the FMCSR handbook within the previous 36 months prior to qualification
No citations or convictions for Reckless Driving or Careless Endangerment during the 36 month period prior to the order date of the MVR
No DUI charges during the 60 month period prior to the order date of the MVR in a personal or non-commercial vehicle and never in a commercial vehicle
Proficient enough in English to understand highway traffic signs and signals, respond to official inquiries, make entries on reports and records, and converse with the public
Provide and maintain proper levels and types of approved insurance during your lease with Landstar including: Unladen Liability and Occupational Accident coverage or, in some cases, statutory Workers' Compensation coverage are mandatory. If you do not participate in the Unladen Liability and/or CPP (Occupational Accident insurance) programs, you must show comparable Unladen Liability coverage and/or Occupational Accident coverage through acceptable insurance carriers. If statutory Workers' Compensation coverage is required and you do not participate in the fleet workers' compensation plan (FWCP) program, coverage must be provided by licensed carriers with acceptable interstate coverage.
These are minimum operator qualification standards subject to DOT requirements, and Landstar may impose more stringent requirements at its option. The decision whether to qualify an operator will be made by Landstar in its sole discretion and on a case-by-case basis

Personal Information

Please enter your personal information

First Name *

Please Enter Your First Name

Middle Name

Please Enter Your Last Name

Last Name *

Please Enter Your Last Name

SSN *

Please Enter Your Social Security Number

Date of Birth (YYYY-MM-DD) *

Please Enter Your Date of Birth

Address

We need to collect the previous 3 year(s) of residence history. Please fill out all the information below to the best of your ability

Address *

Please Enter Your Address

City *

Please Enter Your City

State *

Please Enter Your State

Zip *

Please Enter Your Zip

Start Date *

Please Enter Date

End Date *

Please Enter Date

Contact

If your cell phone is also your primary phone, enter it in both fields below.

Primary Phone *

Please Enter Your Primary Phone

Cell Phone *

Please Enter Your Cell Phone

Email Address *

Please Enter Your Email Address

Confirm Email Address *

Please Confirm Email Address

Preferred method of contact

Best time to contact you

Current License Details:

License Number *

Please Enter Your License Number

License Country *

License State/Province *

License Expiration (YYYY-MM-DD) *

Please Enter Your License Expiration Date

Physical Expiration (YYYY-MM-DD) *

Please Enter Your Physical Expiration Date

Is this a commercial driver license? *

License Class *

License Endorsements *
None
Other
Tanker
Doubles / Triples
X Endorsement
HazMat

HazMat Expiration (YYYY-MM-DD) *

Please Enter Your Physical Expiration Date

Employer/Contract Information

You have indicated that you were employed/contracted from the following dates:

Name

Location

Start Date

End Date

AbraKadabra Company

Miami, FL

2019-02

2021-02

Delete
Update

Roga I Kopyta Company

New York, NY

2015-03

2015-09

Delete
Update

Suka Ja Debil Company

Los Angeles, FL

2010-02

2014-02

Delete
Update

Company Name *

Please Enter Your Company Name

Start Date (YYYY-MM) *

Please Enter Start Date

End Date (YYYY-MM) *

Please Enter End Date

Street Addres *

Please Enter Employer Address

City *

Please Enter Employer City

Country *

State/Province *

Zip/Postal *

Please Enter Zip Code

Phone Number

Please Enter Phone Number

Position Held *

Please Enter Position Held

Reason for leaving? *

Please Enter Reason for leaving

Were you terminated/discharged/laid off? *

Please Explain *

Please Enter Reason

Is this your current employer? *

May we contact this employer at this time? *

Did you operate a commercial motor vehicle? *

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while employed/contracted by this employer/contractor? *

Did you perform any safety sensitive functions in this job, regulated by DOT, and subject to drug and alcohol testing? *

Areas Driven *

Please Enter Areas Driven

Pay Range (cents/mile)

Please Enter Pay Range

Most common truck driven *

Most common trailer *

Trailer length *

Driving School

Have you attended a Driver Training school? *

You have indicated that you were attending driver training during the following dates:

Name

Location

Start Date

End Date

AbraKadabra Driving School

Miami, FL

2019-02

2021-02

Delete
Update

Roga I Kopyta Driving School

New York, NY

2015-03

2015-09

Delete
Update

Suka Ja Debil Driving School

Los Angeles, FL

2010-02

2014-02

Delete
Update

Driving School Name *

Start Date (YYYY-MM) *

Please Enter Start Date

End Date (YYYY-MM) * (If you are currently in school, please enter the current month and year as the End Date)

Please Enter End Date

City *

Please Enter Employer City

Country *

State/Province *

span Phone Number

Please Enter Phone Number

Did you graduate? *

Were you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while attending this truck school? *

Did you perform any safety sensitive functions at this truck school, regulated by DOT, and subject to drug and alcohol testing? *

GPA

Hours of Instruction

Which of the following skills were trained in your program? (Select all that apply) *
Border Crossing
Log Books
Federal Motor Carrier Regulations
Hazardous Materials / Triples

Education Information

Have you attended a school (not related to truck driving) in the last 10 Years? *

You have indicated that you were attending school during the following dates:

School Name

Location

Start Date

End Date

Economic Collage

Miami, FL

2019-02

2021-02

Delete
Update

Mechanical Collage

New York, NY

2015-03

2015-09

Delete
Update

High School Durakov

Los Angeles, FL

2010-02

2014-02

Delete
Update

School name *

Please Enter Phone Number

Start Date (YYYY-MM) *

Please Enter Start Date

End Date (YYYY-MM) * (If you are currently in school, please enter the current month and year as the End Date)

Please Enter End Date

City *

Please Enter Employer City

Country *

State/Province *

Phone Number

Please Enter Phone Number

What did you study? (accounting, mechanic, etc.) *

Please Enter Phone Number

Unemployment

Have you been unemployed at any time within the last 10 years? *

You have indicated that you were attending school during the following dates:

Description

Start Date

End Date

Trip to mars

2019-02

2021-02

Delete
Update

Moon trip

2015-03

2015-09

Delete
Update

Hunting on Jupiter

2010-02

2014-02

Delete
Update

Start Date (YYYY-MM) *

Please Enter Start Date

End Date (YYYY-MM) * (If you are currently unemployed, please enter the current month and year as the End Date)

Please Enter End Date

Comments *

Please Enter Description

Employment History

Description

Type

Start Date

End Date

Missing Dates

Date Gap

2000-02

2021-02

Super Carrier

Employment

2015-03

2000-01

Delete
Update

Missing Dates

Date Gap

2014-07

2015-02

Durak Driving School

Driving School

2012-09

2014-06

Delete
Update

Trip to Mars

Unemployment

2011-02

2012-08

Delete
Update

General Information

What position are you seeking? *

Will you be running as a team? *

What is your team member's name? *

Invalid Text

How many years of commercial driving experience do you have? *

Do you currently have your own authority? *

Are you a Fleet Owner? *

How many trucks do you own? *

Does your truck(s) have Active Brake Assist? *

Enter make, model, and year of each tractor/trailer you own. If you don't own any, enter "None" *

Please Enter Reason

If you are a Driver for Fleet Owner, please list the Fleet Owners name:

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Are you legally eligible for employment in the United States? *

Are you currently employed? *

What date did your last employment end? *

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Do you read, write, and speak English? *

Have you ever qualified or applied with a Landstar company before? *

Enter start and end dates, location, position, and reason for leaving: *

Please Enter Reason

Do you have a current TWIC card? *

Expiration date: *

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Do you have a FAST card? *

Expiration date: *

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Please enter the names of any relatives employed or contracted here: *

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Have you ever been known by any other name? *

Enter name: *

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Who referred you?

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In case of Emergency, notify (list name, address, and phone): *

Please Enter Reason

HAZARDOUS MATERIALS EXPERIENCE

All operators are required to have hazardous materials endorsement before qualification

Have you ever hauled hazardous materials? *

What kind of Hazmat? *

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How many years of experience? *

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DRIVING EXPERIENCE

VAN *

Years of experience *

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Total Miles *

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Have you ever hauled:

Hi-Value Products *

Ammunition / Explosives *

Beer *

Steel Coils in Vans *

Have you ever hauled:

Blanket Wrap / Decking *

Blocking and Bracing *

J.I.T. / Automotive Shipments *

Other *

Please Enter Reason

FLATBED *

Years of experience *

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Total Miles *

Invalid Text

Have you ever hauled:

Coiled Steel *

Sheet Steel *

Bars / Rods *

Reels of Cable *

Wallboard *

Steel Pipe *

Plastic Pipe *

Vehicles *

Machinery *

Lumber *

Do you have experience with:

Chains, Binders, and Edge Protectors *

Straps *

Full Tarps *

Top Tarps with Side Kits *

Multiple Tarps *

Use of Coil Racks *

Over Dimensional Cargo *

Double Drop or Step Deck Trailers *

Heavy Haul Loads with Specialized Equipment *

Vehicle Ramps *

SPECIALIZED EQUIPMENT *

Years of experience *

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Total Miles *

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Have you ever hauled:

Automobiles *

Earth Moving Equipment *

Cranes *

Heavy Machinery *

Farm Implements *

Jet Engines *

Steel or Concrete Beams *

Fiberglass Tanks *

Containers / Chassis *

Other (describe)

Please Enter Reason

Do you have experience with:

Auto Hauling Trailers *

Step Deck Trailers *

Double Deck Trailers *

Removable Gooseneck Trailers *

Number of loads up to 10 feet wide *

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Number of loads between 10 feet and 12 feet wide *

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Number of loads between 12 feet and 14 feet wide *

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Number of loads over 14 feet wide *

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Number of loads up to 14 feet high (loaded height) *

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Number of loads between 14 feet and 15 feet high (loaded height) *

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Number of loads between 15 feet and 16 feet high (loaded height) *

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Number of loads up to 16 feet high (loaded height) *

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Multi-axle *

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Total number of axles *

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Stretch Trailers (what type) *

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Stretch Trailers (overall length) *

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Overweight loads - max gross weight *

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Other HH experience *

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Route Planning / Permit Ordering (max gross weight) *

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LCV (Long Combination Vehicle) doubles and triples *

Are you LCV1 Certified (doubles)? *

Are you LCV2 Certified (triples)? *

CRIMINAL INFORMATION

Have you ever been convicted or forfeited bond or collateral upon a charge of any of the following:

Driving under the influence of alcohol or any drug or controlled substance under either federal or state law? *

Date(s) *

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Court *

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Transportation, possession or unlawful use of any drug or controlled substance while on duty as a driver of a commercial motor vehicle? *

Date(s) *

Invalid Text

Court *

Invalid Text

Leaving the scene of an accident? *

Were you in a commercial vehicle? *

Date(s) *

Invalid Text

Court *

Invalid Text

A felony involving the use of a motor vehicle? *

Were you in a commercial vehicle? *

Date(s) *

Invalid Text

Court *

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Causing a fatality through the negligent operation of a commercial motor vehicle? *

Date(s) *

Invalid Text

Court *

Invalid Text

Driving a commercial motor vehicle without obtaining a CDL, without a CDL in your possession or without the proper class of CDL and/or without the necessary endorsements? *

Date(s) *

Invalid Text

Court *

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Violating any federal, state or local law governing railroad-highway grade crossings while operating a commercial motor vehicle? *

Date(s) *

Invalid Text

Court *

Invalid Text

Violating a driver or vehicle out-of-service order? *

Were hazardous materials involved? *

Was a more than 15 passenger transport vehicle involved? *

Date(s) *

Invalid Text

Court *

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Have you ever tested positive or refused to test on any pre-employment drug or alcohol test during the past 3 years? *

Date(s) *

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Court *

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Have you ever tested positive or refused a test required by any state or jurisdiction under its implied consent law? *

Date(s) *

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Jurisdiction *

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Have you ever been convicted of a felony or released from prison in the past? *

Expl ain fully *

Please Enter Reason

Have you ever plead no contest, nolo contendere, or guilty to a crime (i.e. misdemeanor or felony), or been convicted of a crime? *

Date(s) *

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Court *

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Crime *

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Misdemeanor *

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Felony *

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Are any charges pending against you? *

Date(s) *

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Court *

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Misdemeanor *

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Felony *

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Has any adjudication of any of the above listed charges or violations ever been postponed, deferred or withheld on good behaviour, or for any other reason? *

Date(s) *

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Court *

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Charge *

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Has your license ever been revoked, suspended, canceled or withdrawn, or have you been denied an operator's license, permit or privilege for any reason including failure to pay ticket? *

Date(s) *

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Reason(s) *

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Moving Violation:

List all violations of motor vehicle laws or ordinances of which you were convicted or forfeited bond or collateral, including roadside violations in the last 5 years (other then parking).

Traffic Incidents Overview:

Charge / Description

Location

Date

Fine

Improper passing

2019-02

$0-$99

Delete
Update

Speeding 5-10mph

2015-03

$0-$99

Delete
Update

Speeding over 15mph

2017-02

$400-$500

Delete
Update

Violation Date(YYYY-MM) *

Please Enter Start Date

Charge / Description *

State / Province *

Were you in a Commercial Vehicle? *

Penalty / Fine (Check all that apply) *
Fine
Suspension
Revocation
Community Service
Other

Fine Amount (if applicable)

Comments. If you answered "Other" to any question, please provide additional detail:

Please Enter Reason

Accidents:

List all violations of motor vehicle laws or ordinances of which you were convicted or forfeited bond or collateral, including roadside violations in the last 5 years (other then parking).

Accidents Overview:

Accidents Description

Location

Date

Ticketed

Injury

2019-02

Yes

Delete
Update

Non Injury

2015-03

Delete
Update

Non Injury

2017-02

Yes

Delete
Update

Were you involved in any accidents/incidents with any vehicle in the last 5 years (even if not at fault)? *

Date of Accident / Incident(YYYY-MM) *

Please Enter Date

Type of Accident / Incident *

Hazmat Accident / Incident *

Type of Accident / Incident *

Was the vehicle towed away?

City *

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State/Providence *

Were you in a commercial vehicle? *

If yes, was this a Department of Transportation recordable accident? *

Were you at fault? *

Were you ticketed? *

Please enter detailed information about this accident, whether the accident was chargeable, recordable, reportable, or your faul *

Please Enter Reason

Summarising:

HAPPY END, ALL INFORMATION SUBMITED TO DB

PRE-EMPLOYMENT APPLICATION

Thank you for your interest in our offer.

To fill out this form, you will need to know the following:

Requirements:

To qualify with Carrier, you must meet the following criteria:

Personal Information

Address

Contact

Current License Details:

Employer/Contract Information

Driving School

Education Information

Unemployment

Employment History

General Information

HAZARDOUS MATERIALS EXPERIENCE

DRIVING EXPERIENCE

Have you ever hauled:

Have you ever hauled:

Have you ever hauled:

Do you have experience with:

Have you ever hauled:

Do you have experience with:

CRIMINAL INFORMATION

Moving Violation:

Accidents:

Summarising: