Online application

Tocci & Associates, Inc - Truck Driver Recruiting since 1997

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Driver Application Form - last 3 yrs work history: ( missing info I can get by by phone/email) 4biglou.com is a https:// (secure) site.

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Name: *

SS# & DOB:

Address, City, State & Zip: *

E-mail address: *

Telephone & cell # *

CDLA # & State & exp date:

How Many moving Violations last 3 yrs? What & when?:

How Many Accidents last 3 yrs? What & When?:

Any Felonies or Midemeanors convictions? When & What?

Have you ever tested positive DOT random or pre employment drug screening? if yes , when?

Any DUI or DWI convictions? if so when?

Current Employer, location , Dates employed, # of States, Reason for leaving:

Next Employer, location , Dates employed, # of States, reason for leaving:

Type any other comments or job history if you need room . the box expands so type away.

Captcha (spam protection code) *

I herby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I am aware that I can revoke my consent at any time.

Note: Fields marked with * are required

By clicking submit on this form. I am certifying that the information is true & correct to the best of my knowledge. I authorize Tocci & Assoc, Inc to submit my info to trucking co. that might have an interest in in hiring me. I also give my permission to run a backround check in accordance with state & federal law such as DAC/USIS /HireRight report, MVR report (driving record) etc. I hereby release such persons from any liability or damages. I also understand this is a not a guarantee of employment.

This application will be forwarded to my personal email. I will call you shortly after I receive it & we can review it together & discuss the co. that might be right for you. If you need me or have any further questions please call me:

"Big Lou" Tocci/Tocci & Assoc Inc ( 470) 228-2125 text line/rings to cell or ( 770)

965-6000 if you get voicemail, please leave me a messsge & I will call you back asap.
also if you want to email me any questions or comments not on this form my personal email is: BigLouTruckMan@gmail or BigLou@4BigLou.com

, any other addional info I can take by telephone when we talk.

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"Big Lou" Text/cell (470) 228-2125 or 770-965-6000

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