COVAN - APPLICATION FOR PROFESSIONAL DRIVER
NAME:		ADDRESS:
Last:		Street:
First:		City:
Middle:		State:		Zip Code
Social Security #:		Phone Number:		DOB:
Have you ever been convicted of driving under the influence of alcohol or drugs? Yes No					If "YES" When?

DRIVERS LICENSE INFORMATION:		EXPERIENCE LEVEL:
License #:		Years:	Months:
State:	Expires:	Number of traffic violations in last 3 years:
CDL Class:		Number of traffic accidents in last 3 years:

EMPLOYMENT HISTORY
Company:
Address:
City:		State:		Zip Code
Phone Number:
Position: Straight Truck Tractor Trailer				From: To:
Reason For Leaving: Terminated Quit				If Terminated Explain:
Covan World-Wide Moving, Inc, /Coleman American Moving Services, Inc, is committed to equal opportunity in vendor selection, employment and service and does not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or citizenship or veteran status as provided by law. We comply with all applicable non-discrimination and affirmative action provisions provided under applicable regulation and by law. We expect all sub-contractors and vendors to adhere to all state and federal laws and/or other regulations relating to equal employment opportunity, affirmative action and those prohibiting discrimination.