Driver Application | AZ Aggregate Transport

Section 1

Position & Availability

Position applying for *Date available to start *Desired pay Employment type

How did you hear about us?

Section 2

Personal Information

First name *Middle name Last name *

Phone *Email *Date of birth *Social Security No. (optional, may be provided after offer)

Current street address *

Are you legally eligible to work in the U.S.?

YesNo

Can you perform the essential job functions, with or without accommodation?

YesNo

Section 3

Residence History (Past 3 Years)

Previous address 1

From To

Previous address 2

From To

Section 4

Driver's License & Endorsements

CDL number *State of issue *Class *Expiration date *

Has any license ever been denied, suspended, or revoked?

YesNo

If yes, explain

Section 5

Driving Experience

Total years of CDL experience Years driving dump trucks

States / regions driven

Section 6

Accident & Conviction Record (Past 3 Years)

Any accidents in the past 3 years?

YesNo

Accident details (date, nature, fatalities, injuries)

Any traffic convictions or forfeitures in the past 3 years (other than parking)?

YesNo

Conviction details (date, location, charge, penalty)

Section 7

Employment History (Past 10 Years)

List your most recent employers first. DOT requires 10 years of history for safety-sensitive driving positions. Out of room? Attach a resume below and note “see resume.”

Section 8

Required Documents

Snap a clear photo or upload a scan of each. Images or PDF, ideally under 5MB each. On a phone these open straight to your camera.

Driver's License (Front) *(photo or scan)Driver's License (Back) *(photo or scan)DOT Medical Card / Examiner's Certificate *(photo or scan)Resume (PDF, DOC or DOCX, optional)

Section 9

Authorization & Signature

I certify that all information in this application is true and complete to the best of my knowledge, and I understand that false statements are grounds for rejection or dismissal.I authorize AZ Aggregate Transport to investigate my background, including driving record, employment history, and PSP report, in accordance with the FCRA.I understand this is a safety-sensitive position subject to DOT drug & alcohol testing, including pre-employment testing.

Signature (type your full legal name) *Date *

Your application and resume are emailed directly to our hiring team. We'll reach out about next steps.