HIRES – UG TecH LLC

Applicant Information

First Name

Middle Name

Last Name

Phone *

Email Address *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Date of Birth *

Month *

Day *

Year *

CDL Class? *CLASS A

Driver’s License Number *

State of Issuance *

Vehicle Information

Vehicle Model *

Vehicle Make *

Vehicle Year *

License Plate Number

Insurance Provider

Insurance Policy Number

Experience and Skills

Freight ExperienceDryvanRefrigeratedFlatbed / StepdeckOther

Years of Commercial Driving Experience

Availability

Are you available for long-haul routes?OTR (3-4 week out of Home)Weekly (Every Weekend at Home)

Preferred Working Hours or Routes

Reference 1 Full Name

Reference 1 Phone

Reference 2 Full Name

Reference 2 Phone