Call Us: 800-541-1028 or 920-727-0720


Download Application


Download Here!!

Fax Application to: 888-519-2125

or

Email Application to: safetyemailgroup@ecklundlogistics.com




Or

Fill Out Online Application
_____________________________________________________________________________________________________________



Personal Information:
First Name: Middle: Last Name:
Address 1:
Address 2:
City: State: Zip:
Daytime Phone: Cell Phone:
Email Address:
Date Available To Hire:
<December 2017>
SunMonTueWedThuFriSat
262728293012
3456789
10111213141516
17181920212223
24252627282930
31123456
CDL Information:
Do You Have A Valid CDL?:
SSN#: Date Of Birth:
DL#: Issued State:
Expiration Date#:

Driving History:
Number of accidents involved:
Number of preventable accidents:
Number of rollover accidents:
Number of tickets:
Number of preventable tickets:
Number of reckless tickets:
Additional Driving History:
Employment History:
Currently Employed?:
Number of jobs in last 3 years:
Current Employer:
Employer Name:
Address: Phone:
City: State: Zip:
Start Date: End Date:
Position Held: Pay Rate:
Supervisor: May We Contact?:
Reason Left:
Vehicle Driven: Trailer Length:
_____________________________________________________________________________________________________________

Preferences:
Check all that apply?:            
A.    
B.    
C.    
D.    
E.    
F.    
Have you ever been convicted of a felony?:
Have you ever been convicted of a crime or have any charges pending?:
Have you ever been denied a license, permit or privilege to operate a motor vehicle?:
Has any license, permit or privilege ever been suspended or revoked?:
Have you ever tested positive or refused a test for drugs or alcohol?:
Have you ever abandoned your equipment?
If you answered yes to any of the above questions, please explain in the space provided below:


This certifies that this application was completed by myself and all information contained within the application are true and complete to the best of my knowledge. I hereby authorize Ecklund Logistics, Inc. and their agents to conduct a background investigation that may include past employment, criminal history, DAC and MVR.


I have read and agree to the above release and I give permission to obtain consumer reports about me from DAC and my MVR.
Type In Full Name For Signature:


   





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