Driving Application

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Driving Application

11/16/2024

recruiting@exploregroup.us

Step 1 of 5

Name
First Last
Email
Residence history past 3 years
Address City State ZIP Country
SSN/SIN
Primary Phone
Cell Phone
DOB
Month
Day
Year
Yes, I want to receive information and communications from Explore Group concerning future opportunities or promotions.
- Yes
- No
What type of application
- Owner Operator Driver
- Owner Operator Non-Driver
- Driver for Owner Operator
What position are you applying for?
- Sand
- Reefer
- Dry Van
- Step Deck
- Pneumatic
- Oil Hauler
Owner Operator Name
Equipment Description
Type
Year
Make
Model
Color
VIN
Weight
Mileage
Fifth Wheel Height
What location are you applying for?
Will you lease our trailer or use your own?
- Lease
- Own
Year
Make
Model
Are you legally eligible for employment in the United States?
- Yes
- No
Are you currently employed?
- Yes
- No
What date did your last employment end?
Month
Day
Year
Do you read, write, and speak English?
- Yes
- No
Have you ever worked for this company before?
- Yes
- No
Start Date
Month
Day
Year
End Date
Month
Day
Year
Location
Position
Reason for leaving
Do you currently have a TWIC card?
- Yes
- No
Expiration Date
Month
Day
Year
Enter names of any relatives employed here
Have you ever been known by any other name?
- Yes
- No
Enter name:
How did you hear about us?
If "Driver Referral" please enter driver's name
In case of emergency, notify (Name)
In case of emergency, notify (Phone)
In case of emergency, notify (Address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Driving Experience
Type of equipment (Van, reefer, tank, etc.) Start date (MM/YY) End date (MM/YY) Approximate total mileage
Which safe driving awards do you hold?
From whom?
Highest education grade completed
Last school attended (Name, city, state)
Personal References
First Reference Name
First Reference Phone
First Reference Relationship
First Reference Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Second Reference Name
Second Reference Phone
Second Reference Relationship
Second Reference Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Licenses
License # State Country Class License Exp. Date (MM/YY) Physical Exp. Date (MM/YY) Current License? (Y/N) CDL? (Y/N) Endorsements
Upload CDL Front and Back
Drop files here or

Max. file size: 455 MB.
Upload SSC
Drop files here or

Max. file size: 455 MB.
Upload Medical Card
Drop files here or

Max. file size: 455 MB.
Upload Title or Title Application Receipt
Drop files here or

Max. file size: 455 MB.
Upload Registration
Drop files here or

Max. file size: 455 MB.
Upload 2290
Drop files here or

Max. file size: 455 MB.
Upload DOT Annual Inspection
Drop files here or

Max. file size: 455 MB.
Upload Bobtail Insurance
Drop files here or

Max. file size: 455 MB.

THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY ALL ACCOUNT HOLDERS
IMPORTANT DISCLOSURE REGARDING BACKGROUND REPORTS FROM THE PSP Online Service
In connection with your application for employment with Explore Logistics, LLC. (“Prospective Employer”), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).
When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.
When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.
Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.
Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.
The Prospective Employer cannot obtain background reports from FMCSA without your authorization.
AUTHORIZATION
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:
I authorize Explore Logistics, LLC. (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.
I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.
I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.
Prospective Employer
Name
Date
Month
Day
Year
Signature
NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant’s written or electronic consent prior to accessing the Applicant’s PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant’s consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language.

Company	Start Date (MM/YY)	End Date (MM/YY)	Address	City/State/ZIP	Phone	Email	Position Held	Reason for leaving	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?	Materials hauled

Driving Application

recruiting@exploregroup.us

Step 1 of 5

Equipment Description

Personal References

Employment

Unemployment

FMCSR

Signature

THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY ALL ACCOUNT HOLDERS

IMPORTANT DISCLOSURE REGARDING BACKGROUND REPORTS FROM THE PSP Online Service

AUTHORIZATION

General Consent for Limited Queries of the FMCSA Drug & Alcohol Clearinghouse

Driver Authorization

Address	City	State	ZIP	Country

Type of equipment (Van, reefer, tank, etc.)	Start date (MM/YY)	End date (MM/YY)	Approximate total mileage

License #	State	Country	Class	License Exp. Date (MM/YY)	Physical Exp. Date (MM/YY)	Current License? (Y/N)	CDL? (Y/N)	Endorsements