PENNY LEE TRUCKING, INC.

APPLICATION FOR EMPLOYMENT

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.

Date

Name
Address
City State Zip
Drivers License# Class A CDL
 SS# Phone # Date of Birth

Federal law prohibits the employment of unauthorized aliens.  All persons hired must submit satisfactory proof of employment authorization and identity (valid driver's license, birth certificate, Green Card, etc.) within three days of being hired.  Failure to submit such proof within the required time shall result in immediate employment termination.

Position Applied For

Past Employment

Company Name  
Address  
Position Held Dates Employed
Manager/Supervisor Telephone
Wage/Salary Reason for Leaving

Company Name  
Address  
Position Held Dates Employed
Manager/Supervisor Telephone
Wage/Salary Reason for Leaving

Company Name  
Address  
Position Held Dates Employed
Manager/Supervisor Telephone
Wage/Salary Reason for Leaving

Driving Experience -  Please check the box you have experience in.

Dump Truck and Trailer- Water Truck- Transfer Truck- 
Sweeper Truck- Flat bed- Equipment Operator- Lowboy- 
Dispatcher- Belly Dump- Forman/Superintendant-
 Concrete Tub- Estimator- Debris Tub-

Mechanical Experience - Please check the box you have experience in.

Drive Line Componants- Body Work-   
Diesel engine Tune up and Rebuild- Electrical Repair- 
Gas engine Tune up and Rebuild- Frame & Wheel Alignment-
Tire Service- Brakes- Trailer Repair- Cooling System- 
Air-Conditioning- Inspections- Diesel Injection Systems- 
Electric Welder- Oxyacetylene Welder-
Paint Spray Gun- Exhaust System- Greasing Servicing-

Work Availability

When are you available for work?
Do you have any objection to working overtime?  Yes No
Can you work overtime without prior notice?       Yes No
Can you work on Saturday?                                  Yes No
Can you work on Sunday?                                    Yes No
Can you travel if required by this position?           Yes No

Salary / Hourly Rate Requirements $per

PLEASE SUBMIT ONE TIME ONLY. THANK YOU