Driver Application | JASKO Enterprises, Inc.

Personal Information

Tell us who you are and how to reach you.

First Name *

Middle Name

Last Name *

Suffix

Date of Birth *

Federal regulations generally permit interstate commercial driving beginning at age 21. JASKO Enterprises, Inc. requires company-driver applicants to be at least 23 years old, subject to applicable qualification and insurance requirements.

Social Security Number *

Required for the background check. Stored encrypted, never shown in full.

Primary Phone *

Alternate Phone

Email Address *

Street Address *

Apt / Unit

City *

State *

ZIP *

Years at This Address *

PREVIOUS ADDRESSES (if less than 3 years at current)

Previous address 1

Street

City

State

ZIP

Previous address 2

Street

City

State

ZIP

License & Medical

Your CDL and DOT medical card details.

CDL Class *

License State *

CDL Number *

CDL Expiration *

Endorsements

Restrictions

Medical Card Expiration *

Medical Restrictions

Driving Experience

What you've driven and for how long.

Equipment Types Driven *

Years of CDL Experience *

Approximate Lifetime Miles

Employment History

FMCSA requires 10 years of history. Start with your most recent employer. Explain any gaps below.

Employer #1

Company Name *

Phone

Position Held

Street Address

City

State

ZIP

Date From

Date To

Reason for Leaving

I currently work here May we contact this employer?

Yes No

Explain Any Gaps in Employment

Accidents & Traffic Violations

List accidents from the past 3 years and moving violations from the past 3–5 years. Leave blank if none.

ACCIDENTS (3 years)

Accident #1

Date

Location

Description

Injuries involved

Fatalities involved

TRAFFIC VIOLATIONS (3–5 years)

Violation #1

Date

Location

Charge / Offense

Penalty

Disclosures & Consent

FMCSA-required questions. Answer honestly — a "yes" does not automatically disqualify you, but a false answer will.

Has your driver's license ever been denied, suspended, or revoked? *

Yes No

Have you ever been convicted of a felony? *

Yes No

Have you ever been convicted of DUI / DWI? *

Yes No

Have you ever refused a DOT drug or alcohol test? *

Yes No

Have you ever tested positive on a DOT drug or alcohol test? *

Yes No

Have you ever failed to complete a DOT return-to-duty process? *

Yes No

In the past 2 years, were you subject to FMCSA drug & alcohol testing rules? *

Yes No

If you answered YES to any question above, explain

AUTHORIZATION & CONSENT

All five are required to process your application. Each disclosure opens in a new tab — read it, then check the box.

I authorize JASKO Enterprises, Inc. to obtain my PSP (Pre-Employment Screening Program) report from FMCSA. *

Read the PSP Disclosure & Authorization →

I authorize JASKO Enterprises, Inc. to obtain my Motor Vehicle Record (MVR) for employment purposes. *

Read the MVR Disclosure & Authorization →

I authorize a background investigation, including criminal history, driving record, and prior employment verification. * I consent to pre-employment DOT drug and alcohol testing, and to ongoing testing as required by FMCSA regulations. * I certify that the information in this application is true and complete. I understand that false statements are grounds for disqualification or termination. *

Review & Signature

Review your entries, then sign electronically to submit.

Electronic Signature — Type Your Full Legal Name *

Date *

By typing your name you electronically sign this application and certify it is true and complete.

Your Social Security Number is encrypted before storage and is never displayed in full — not even to you. JASKO Enterprises, Inc. uses this information solely for employment screening as required by FMCSA regulations.