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Yes No Are you lawfully authorized to work in the U.S? Yes No I am applying as a: Class A Driver Class B Driver Local Driver What position are you applying for?Upload resume (If applicable)Max. file size: 450 MB.Who referred you to Capital?If applying for a Laborer, Operator, or Driver position you must be able to lift up to 50 lbs. on a regular basis, must be able to stoop, bend, and work in extreme temperatures. Can you perform these essential job duties with or without an accommodation? Yes No List all States in which you have held a driver’s license (at least 3 years must be shown). Please list State, License No., Class, Endorsements, and Expiration Date.1. Have you ever been denied a license or privilege to operate a motor vehicle? Yes No 2. Has any license, permit or privilege ever been suspended or revoked? Yes No 3. Have you ever been disqualified to drive a Commercial Motor Vehicle under the Federal Motor Carrier Safety Regulations? Yes No If your answer to 1, 2, or 3 above is yes, please explain:Driving Experience - Please list Class of Equipment (Straight Truck, Tractor Trailer, Other), Type (dump, flat bed, etc.), Dates, Approx. MilesSafety Record - List all accidents for the past 5 years. Please list Dates, Describe Accident, Injuries or Fatalities?Special Skills (heavy equipment operator, mechanical maintenance, construction, forklift, etc.) - Please list Dates, Type of Skill/ExperienceEducation - Please list Name of School, Location, Dates Attended, and DegreeName of Present or Last EmployerPlease include your employment for the past 10 years.PhoneAddress Street Address City State / Province / Region ZIP / Postal Code Starting Date MM slash DD slash YYYY Leaving Date MM slash DD slash YYYY Reason for LeavingEnding WageMay we contact to verify your employment? Yes No Previous EmployerPhoneAddress Street Address City State / Province / Region ZIP / Postal Code Starting Date MM slash DD slash YYYY Leaving Date MM slash DD slash YYYY Reason for LeavingEnding WageMay we contact to verify your employment? Yes No Previous EmployerPhoneAddress Street Address City State / Province / Region ZIP / Postal Code Starting Date MM slash DD slash YYYY Leaving Date MM slash DD slash YYYY Reason for LeavingEnding WageMay we contact to verify your employment? Yes No References - List three professional references (do not list relatives). Please list name, street address, and phone number.“I certify that I have read and understood the employment application, and I am submitting this application for the sole purpose of seeking employment with Capital. It is agreed and understood that Capital, or its agents may investigate my background and employment history, whether same is of record or not. I understand that this information will be used for the purpose of determining my eligibility for employment with Capital. I authorize, without reservation, any party or agency contacted by Capital to furnish requested information concerning my work history and character. I release all employers, USIS, and other persons named herein from all liability for damages due to furnishing such information. I certify that this application was completed by me and all answers I have given are truthful to the best of my knowledge. I understand that any misrepresentations or omissions may result in my rejection for consideration or dismissal. Copies of this document carry the same authority as the original document. I agree to furnish additional information, i.e. social security number, and complete examinations and drug tests as may be required.”I agree to the above authorization I agree Your NameDate MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged. Δ