1-833-231-0911

info@trafficade.com

2533 West Holly St.

Phoenix, AZ 85009

Open 7 Days a Week

Open 24 hrs

PROMPT, DEPENDABLE, FRIENDLY

Established 1990

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CDL Application

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CDL Application

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CDL Application For Employment
Company
Street Address
City
State
ZIP Code
First Name
Middle Name
Last Name
Maiden Name (if any)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How long have you lived at this address?
Date of Birth
Date Format: MM slash DD slash YYYY
Social Security Number
Hire Date
Date Format: MM slash DD slash YYYY
Phone
Email
Previous Three Years Residency
Address #1
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
# of Years
Address #2
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
# of Years
Address #3
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
# of Years
Please attach a file if more information is needed.
Drop files here or

Accepted file types: pdf, docm, doc, docx, dotx, txt, dotm, docb, pages, one.
License Information
Section 383.21 FM CSR states “No person who operates a commercial motor vehicle shall at any time have more than one driver’s license”. I certify that I do not have more than one motor vehicle license, the information which is listed below.
State
License #
Type
Expiration Date
Driving Experience
Straight Truck - Type of Equipment (Van, Tank, Truck, etc.)
Approximate # of Miles (Total)
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Tractor and Semi-Trailer - Type of Equipment (Van, Tank, Truck, etc.)
Approximate # of Miles (Total)
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Tractor Two-Trailers - Type of Equipment (Van, Tank, Truck, etc.)
Approximate # of Miles (Total)
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Other - Type of Equipment (Van, Tank, Truck, etc.)
Approximate # of Miles (Total)
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Accident Record For The Last Three Years Or More
Date of Incident #1
Date Format: MM slash DD slash YYYY
Nature of Accident (Head-On, Rear-End, Upset, etc)
Number of Fatalities
Please enter a number from 0 to 25.
Number of Injuries
Please enter a number from 0 to 25.
Chemical Spills
- Yes
- No
Date of Incident #2
Date Format: MM slash DD slash YYYY
Nature of Accident (Head-On, Rear-End, Upset, etc)
Number of Fatalities
Please enter a number from 0 to 25.
Number of Injuries
Please enter a number from 0 to 25.
Chemical Spills
- Yes
- No
Date of Incident #3
Date Format: MM slash DD slash YYYY
Nature of Accident (Head-On, Rear-End, Upset, etc)
Number of Fatalities
Please enter a number from 0 to 25.
Number of Injuries
Please enter a number from 0 to 25.
Chemical Spills
- Yes
- No
Please attach a file if more information is needed.
Drop files here or

Accepted file types: pdf, docm, doc, docx, dotx, txt, dotm, docb, pages, one.
Traffic Convictions and Forfeitures For The Past Three Years (other than parking violations)
Date Convicted #1
Date Format: MM slash DD slash YYYY
Violation
State of Violation Location
Penalty (forfeiture bond, collateral and/or points)
Date Convicted #2
Date Format: MM slash DD slash YYYY
Violation
State of Violation Location
Penalty (forfeiture bond, collateral and/or points)
Date Convicted #3
Date Format: MM slash DD slash YYYY
Violation
State of Violation Location
Penalty (forfeiture bond, collateral and/or points)
Please attach a file if more information is needed.
Drop files here or

Accepted file types: pdf, docm, doc, docx, dotx, txt, dotm, docb, pages, one.
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
- Yes
- No
If yes, explain
Has any license, permit or privilege ever been suspended or revoked?
- Yes
- No
If yes, explain

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Employment Record
Applicants that desire to drive intrastate/interstate commerce must provide the following information on all employers during the previous three years. You must give the same information to all employers if you have driven a commercial motor vehicle for the seven years prior to the initial three years (total of ten years employment record).
MUST LIST THE COMPLETE MAILING ADDRESS: STREET NUMBER AND NAME, CITY, STATE AND ZIP CODE
Last Employer: Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position Held
Hourly / Salary Rate
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason For Leaving
ANY GAPS IN EMPLOYMENTAND/OR UNEMPLOYMENT MUST BE EXPLAINED. INCLUDE DATES (MONTH/YEAR) AND REASON
Were you subject to the Federal Motor Carriers Safety Regulations (FMCSRs) while employed by the previous employer?
- Yes
- No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substance testing requirements as required by 49 CFR Part 40?
- Yes
- No
Second Last Employer: Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position Held
Hourly / Salary Rate
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason For Leaving
ANY GAPS IN EMPLOYMENTAND/OR UNEMPLOYMENT MUST BE EXPLAINED. INCLUDE DATES (MONTH/YEAR) AND REASON
Were you subject to the Federal Motor Carriers Safety Regulations (FMCSRs) while employed by the previous employer?
- Yes
- No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substance testing requirements as required by 49 CFR Part 40?
- Yes
- No
Third Last Employer: Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Position Held
Hourly / Salary Rate
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason For Leaving
ANY GAPS IN EMPLOYMENTAND/OR UNEMPLOYMENT MUST BE EXPLAINED. INCLUDE DATES (MONTH/YEAR) AND REASON
Were you subject to the Federal Motor Carriers Safety Regulations (FMCSRs) while employed by the previous employer?
- Yes
- No
Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substance testing requirements as required by 49 CFR Part 40?
- Yes
- No
Please attach a file if more information is needed.
Accepted file types: pdf, docm, doc, docx, dotx, txt, dotm, docb, pages, one.
TO BE READ AND SIGNED BY APPLICANT
I authorize you to make sure investigations and inquires, into my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquires regarding medical history will be made only if and after a conditional offer of employment has been extended). I herby release employers, schools, health care providers and other persons from all liability in responding to inquires 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 understand, also, that I am required to abide by all rules and regulations of the company. “I understand that information I provide regarding current and/or previous employers may be used, and those employers(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). 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 re-send the corrected information to the prospective employer, and;
- Have the rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
Electronic Signature (Full Name)
Today's Date
Date Format: MM slash DD slash YYYY
The electronic signature above 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.
Electronic Signature (Full Name)
Today's Date
Date Format: MM slash DD slash YYYY
NOTE: A motor carrier may require an applicant to provide information in addition to the information required by Federal Motor Carrier Safety Regulation.
BEFORE COMPLETION AND SUBMISSION OF THIS FORM, PLEASE DOWNLOAD THE FOLLOWING PDF TO BE FILLED OUT BY PROSPECTIVE EMPLOYEE AND PREVIOUS EMPLOYER

*Click here to download form
*Upload completed CDL Drivers Safety Performance History Records Request
Accepted file types: pdf, docm, doc, docx, dotx, txt, dotm, docb, pages, one.

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About Us

Established in 1990, Trafficade is Arizona’s largest traffic control company that is locally owned and family operated. We are diversified, with divisions specializing in:

Barricades and Traffic Control
Trench Shoring & Steel Road Plates
Asphalt Trench Paving & Repair Paving
Pavement Milling and Saw Cutting
Sign Manufacturing and Safety Product Sales
Flagging Services

Corporate Office

2533 West Holly St., Phoenix, AZ 85009

1-833-231-0911

info@trafficade.com

602-272-2827

Open 24 hours, 7 days a week

© Copyright 2020 Trafficade All rights reserved.

Home
About Us
Barricade
Shoring
Milling & Paving
Signs & Sales
Contact Us
Jobs