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CLASS A CDL QUALIFICATION SCREENING
CLASS A CDL JOB QUALIFICATION SCREENING
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First Name
Last Name
Email
Phone
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Location
Do you an application in process with any other carriers? If so, which ones?
Have you recently been denied by any carriers?
Yes
No
Who are you currently employed with?
What are you looking for in your next driving job?
Have you had your Class A CDL for more than 1 year? If not, what trucking school did you attend?
How much LOCAL experience do you have?
How much OTR experience do you have?
What types of transmissions do you have experience driving?
10 Speed
13 Speed
18 peed
Automatic
Any Auto-Restrictions
What types of trailers do you have experience driving?
Dry Van
Reefer
Tanker/Pneumatic Tanker
Flatbad
Doubles/Triples
Retracting Goose Neck
Conestoga
Car Hauler
Other
Do you have any endorsements?
Hazmat
Tanker
Doubles/Triples
TWIC Card
Passport
In the past 10 years have you ever had a:
DUI/DWI
Failed or Refused Drug Test
None Apply
In the last 3 years have you had any:
Moving Violations/Tickets
Accidents/Incidents
License Suspensions
Employment Terminations
Criminal Conviction
None Apply
If you selected yes for any of the above please explain below (the more we know the better, we're on your side)
Can you pass a drug test today?
Yes
No
Have you been unemployed for more than 12 months in the past 3 years?
Yes
No
Additional Comments
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CONTACT US
(301) 539-9751
info@cooperidgeconsultingfirm.com
1910 Towne Centre Blvd. Suite 250 Annapolis, MD 21401
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