Recruitment Form

Page 1 of 5

  1. Welcome to Searcy Trucking Recruitment Page.
  2. Personal Information
  3. First Name*
    Please type your full name.
  4. Middle Name
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  5. Last Name*
    Please type your Last Name
  6. Contact Information
  7. E-mail*
    Please enter your e-mail address.
  8. Primary Phone
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    Format: (XXX) XXX-XXXX
  9. Cell Phone
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  10. Current Address
  11. Address
    Please type address
  12. City*
    Please type city
  13. Postal Code
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  14. Country*
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  15. Province/State*
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  16.  
  1. Educational Qualification
  2. Highest Level of Formal Education
  3. Degree/Diploma*
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  4. School
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  5. Year completed
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  6. Driving/Training Institute Attended (within the past 3 years)
  7. Driving Institute Name
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  8. Date of Graduation
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  9. Screening Questions
  10. Do you have a valid Class 1/A licence?
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  11. Are you FAST approved?
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  12. Do you have any limitations with respect to hand-bombing (50 lbs)?
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  13. Have you ever been convicted of a crime for which a pardon has not been granted?
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  14. Are you willing to be tested for drug and alcohol use on a random basis?
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  15. Date available to begin work
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  16. What position are you applying for?
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  17. If you selected Owner-Operator for applied position, please provide Truck Year and Make
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  18. Are you able to cross the border?
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  19.  
  1. Driving Qualification
  2. Driver Licence Details
  3. Province/State
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  4. Licence Number*
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  5. Licence Type
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  6. Licence Expiration Date
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  7. 1. Have you ever been denied a permit, privilege or licence?
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  8. 2. Has any licence, permit or privilege ever been suspended or revoked>
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  9. If you answered "Yes" to 1 or 2, please give details
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  10. Record all accidents in which you are involved, for the past 3 years, for personal or commercial vehicles
  11. Date of Accident
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  12. Nature of Accident (Head-on/Rear end/etc.)
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  13. Were you deemed 50% or more at fault?
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  14. Type of Vehicle at the time of accident
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  15. Do you want to record another accident?
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  16. Date of Accident
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  17. Nature of Accident (Head-on/Rear end/etc.)
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  18. Were you deemed 50% or more at fault?
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  19. Type of Vehicle at the time of accident
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  20. Do you want to record another accident?
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  21. Date of Accident
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  22. Nature of Accident (Head-on/Rear end/etc.)
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  23. Were you deemed 50% or more at fault?
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  24. Type of Vehicle at the time of accident
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  25. Record all violations in which you are involved, for the past 3 years, for personal or commercial vehicles
  26. Date
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  27. Violation (seatbelt/stop sign/hand held device/etc.)
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  28. Demerits
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  29. Type of Vehicle at the time of violation
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  30. Do you want to record another violation?
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  31. Date
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  32. Violation (seatbelt/stop sign/hand held device/etc.)
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  33. Demerits
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  34. Type of Vehicle at the time of violation
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  35. Do you want to record another violation?
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  36. Date
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  37. Violation (seatbelt/stop sign/hand held device/etc.)
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  38. Demerits
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  39. Type of Vehicle at the time of violation
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  40. Tractor/Trailer Driving Experience
  41. Indicate your commercial driving experience




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  42. Type of Equipment





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  43. Rate your experience for Van
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  44. Rate your experience for Tanker
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  45. Rate your experience for Flatbed
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  46. Rate your experience for Tri-Axle/Tandem
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  47. Rate your experience in Refrigeration
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  48. Rate your experience in Other
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  49.  
  1. EMPLOYMENT HISTORY
    Please list your employment for the past ten (10) years. All time gaps must be accounted for and the reason provided (i.e. unemployed/self-employment/attending school)
  2. LIST EMPLOYERS IN REVERSE ORDER STARTING WITH THE MOST RECENT
  3. Company Name*
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  4. Address
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  5. City
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  6. Province
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  7. Postal Code
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  8. Contact
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  9. Phone No.
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  10. Start Date
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  11. End Date
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  12. Position Held
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  13. Reason for Leaving
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  14. Was your job designated as a safety function subject to drug and alcohol testing under 49 CFR part 40?
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  15. May Searcy contact your present employer (if any) to verify your work record?
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  16. Period of Unemployment (if any)
  17. From Date
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  18. To Date
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  19. Do you want to add more previous employment history?
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  20. Company Name
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  21. Address
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  22. City
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  23. Province
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  24. Postal Code
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  25. Contact
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  26. Phone No.
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  27. Start Date
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  28. End Date
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  29. Position Held
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  30. Reason for Leaving
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  31. Was your job designated as a safety function subject to drug and alcohol testing under 49 CFR part 40?
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  32. Period of Unemployment (if any)
  33. From Date
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  34. To Date
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  35. Do you want to add more previous employment history?
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  36. Company Name
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  37. Address
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  38. City
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  39. Province
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  40. Postal Code
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  41. Contact
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  42. Phone No.
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  43. Start Date
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  44. End Date
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  45. Position Held
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  46. Reason for Leaving
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  47. Was your job designated as a safety function subject to drug and alcohol testing under 49 CFR part 40?
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  48. Period of Unemployment (if any)
  49. From Date
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  50. To Date
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  51. Do you want to add more previous employment history?
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  52. Company Name
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  53. Address
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  54. City
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  55. Province
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  56. Postal Code
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  57. Contact
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  58. Phone No.
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  59. Start Date
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  60. End Date
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  61. Position Held
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  62. Reason for Leaving
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  63. Was your job designated as a safety function subject to drug and alcohol testing under 49 CFR part 40?
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  64. Period of Unemployment (if any)
  65. From Date
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  66. To Date
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  67. Do you want to add more previous employment history?
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  68. Company Name
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  69. Address
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  70. City
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  71. Province
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  72. Postal Code
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  73. Contact
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  74. Phone No.
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  75. Start Date
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  76. End Date
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  77. Position Held
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  78. Reason for Leaving
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  79. Was your job designated as a safety function subject to drug and alcohol testing under 49 CFR part 40?
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  80. Period of Unemployment (if any)
  81. From Date
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  82. To Date
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  83. Do you want to add more previous employment history?
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  84. Company Name
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  85. Address
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  86. City
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  87. Province
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  88. Postal Code
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  89. Contact
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  90. Phone No.
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  91. Start Date
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  92. End Date
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  93. Position Held
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  94. Reason for Leaving
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  95. Was your job designated as a safety function subject to drug and alcohol testing under 49 CFR part 40?
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  96. Period of Unemployment (if any)
  97. From Date
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  98. To Date
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  99. Do you want to add more previous employment history?
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  100. Company Name
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  101. Address
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  102. City
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  103. Province
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  104. Postal Code
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  105. Contact
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  106. Phone No.
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  107. Start Date
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  108. End Date
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  109. Position Held
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  110. Reason for Leaving
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  111. Was your job designated as a safety function subject to drug and alcohol testing under 49 CFR part 40?
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  112. Period of Unemployment (if any)
  113. From Date
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  114. To Date
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  115.  
  1. Additional Information
  2. What is your reason for choosing us as your potential employer?
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  3. How did you hear about this position?





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  4. Please give some details, as you have selected 'Other' option
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  5. Please give the name of Searcy Employee
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  6. Upload Driver Licence
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  7. Terms and Conditions : To be read and agreed by Applicant
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  8. Please check the box to give your consent*
    Please tick the checkbox to give your consent
  9. Please tick the checkbox
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