Application – Rhapsody Logistics

Full DOT application

Personal info

Please fill all the fields below

First Name

Middle Name

Last Name

Date of Birth:

Date available for work:

Phone/Mobile

Residency info

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Current residency Address:

Address Line 1

Address Line 2

City

State

Zip Code

Number of years at this address:

Licence info

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Licence number:

Expiration date:

Driving experience:

Please fill all the fields below

How much verifiable straight truck driving experience do you have?

How much verifiable tractor & trailer driving experience do you have?

How much verifiable tractor & two trailers driving experience do you have?

Accident record:

Please fill all the fields below

Did you have any accidents in the last 3 years?

Yes

Were there any fatalities caused?

Yes

How many fatalities?

Violation record:

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Did you have any traffic convictions and forfeitures for the past 3 years (other than parking violations)

Yes

List them all, one by one:

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

Yes

Please explain:

Has any license, permit, or privilege ever been suspended or revoked?

Yes

Please explain:

Current or most recent employer:

Please fill all the fields below

Name:

Phone number:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Position held:

Date FROM:

Date TO:

Reason for leaving:

Second most recent employer:

Please fill all the fields below

Name:

Phone number:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Position held:

Date FROM:

Date TO:

Reason for leaving:

Salary:

Other previous employers:

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Repeater Container

Name:

Phone number:

Address:

TO BE READ AND SIGNED BY APPLICANT

Authorization and signature are mandatory

I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company.

I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23. I understand that I have the right to:

Review information provided by current/previous employers;
Have errors in the information corrected by previous employers, and for those previous employers to resend the corrected information to the prospective employer; and
Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.

By checking this box, you agree to receive SMS messages from Rhapsody Logistics Inc. regarding your job inquiry, including application updates, interview scheduling, and communication from our recruiting team. Message frequency may vary. Message and data rates may apply. You may opt out at any time by replying STOP.

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Fill out the application form

Personal info

Residency info

Licence info

Driving experience:

Accident record:

Violation record:

Current or most recent employer:

Second most recent employer:

Other previous employers:

TO BE READ AND SIGNED BY APPLICANT