Personal InformationLast Name *First Name *Middle NameStreet Address *City *State *Zip *Driver's License #DL StateCDL?YesNoDate of BirthHome PhoneCell Phone *Do you have a Social Security number/card? *YesNoPosition Desired *Pay ExpectedAvailabilityAre you available for full time work?YesNoWill you work overtime if asked?YesNoDo you have reliable transportation for commuting to jobsite?YesNoAre you legally eligible for employment in the United States?YesNoOther special training or skills (languages, machine operation, etc.)EducationHighest level of school achievedYears completedCourse of StudyDegreePrevious Address (list all locations where you have lived in the past 7 years)Address, City, State (#1)FromToAddress, City, State (#2)FromToAddress, City, State (#3)FromToAddress, City, State (#4)FromToPrevious EmploymentLast CompanyAddressName of SupervisorPhoneJob Type / DescriptionSalaryReason for leavingAdverse Licensing ActionsA. Have you ever been denied a license, permit, or privilege to operate a motor vehicle?YesNoB. Has any license, permit, or privilege to operate a motor vehicle been suspended or revoked?YesNoIf yes to either, please explainEmployment Record (USDOT requires employment history for at least the last 3 years, and Commercial Driving Experience for the past 10 years)Last EmployerNameAddressFromToPosition HeldSalary ($)PerSubject to FMCSRs?YesNoSubject to DOT alcohol/drug testing?YesNoReason for LeavingSecond Last EmployerNameAddressFromToPosition HeldSalary ($)PerSubject to FMCSRs?YesNoSubject to DOT alcohol/drug testing?YesNoReason for LeavingThird Last EmployerNameAddressFromToPosition HeldSalary ($)PerSubject to FMCSRs?YesNoSubject to DOT alcohol/drug testing?YesNoReason for LeavingPlease read the following statements carefully prior to signing this applicationI hereby apply for employment with RCS, Inc. I specifically verify that all the information provided in this employment application is true, complete and correct. I understand and agree that the omission or misrepresentation of any fact in the employment application will be sufficient reason to deny me employment. I also understand and agree that should RCS, Inc. employ me and it is later discovered I have omitted or misrepresented any fact in this employment application, RCS, Inc. may immediately terminate my employment. I will abide by the safety rules of this company. If injured, I authorize my Employer to use his best judgment for treatment unless I instruct otherwise. I also understand that should I be absent for more than two days due to illness, I will be required to have a doctor's permission to return to work. Should I be late for work, should I need extra time off for personal business, I understand that it is my responsibility to notify my immediate supervisor and/or RCS, Inc. Office personnel.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.I have read and agree to the statement aboveApplicant's Signature (type full legal name) *Typing your name here serves as your electronic signature.Date *