CDLSuite | Apex Transportation

Thank you for your application for a non CDL (Commercial Drivers License) position.

Non CDL

Apex Transportation

9800 Alton Way
Henderson , CO 80640
303-288-2233

Job Applied For *

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First Name * Required

Middle Initial *

None

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Last Name * Required

Social Security No. * Required

Mobile Phone No. *

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Other Phone No.

Email Address * Required

Present Address *

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Address 2

City * Required

State/Province * Required

ZIP * Required

County

Yrs at this address * Required

*If at current address less than 5 years, list below most recent addresses for the past 5 years. (Click on the Plus sign to add additional Previous Addresses.)

Previous Address

Address 2

City

State/Province

ZIP

County

Yrs at this address

Previous Address

Address 2

City

State/Province

ZIP

County

Yrs at this address

Do you have your own tools?:* Required

Do you understand this is for 2nd shift?:* Required

Are your able to meet our Insurance Guidelines to go on road calls with our vehicles?:* Required

Driver's Licence or State ID

Name - Exactly as it appears on your driver's license or State ID

Current Driver's License or State ID Number *

Issuing State/Province *

Additional Licenses

List ALL additional licenses held in the past 3 years and ALL unexpired commercial motor vehicle operator's licenses or permits. (Click on the Plus sign to add additional Licenses.) DO NOT enter current license information in this section.

Additional Licenses State/Province

Additional License No

Additional Licenses Expiration Date

Have you ever held a Commercial Drivers License?: Required

Education

Name and Location of School

Years Attended

Diploma/Certification

High school Name and Location of School Required

Required

Years Attended Required

Diploma/Certification Required

College Name and Location of School

Years Attended

Diploma/Certification

Trade or Business
School Name and Location of School

Years Attended

Diploma/Certification

Special Courses:

Where did you get your training for turning wrenches?:* Required

Employment History

You must provide accurate dates of employment and phone numbers for past employers. We cannot hire you without verifying employment. If you need to list additional employers, click "Add Another Employer" below.

EMPLOYER #1

Company * Required

Supervisor's Name

Supervisor Phone *

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Street Address * Required

City * Required

State/Province * Required

Zip Code * Required

Position Held * Required

From Date (mm/yyyy) *

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To Date (mm/yyyy) *

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Still there

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Reason For Leaving * Required

Duties Performed * Required

You can add only 15 employers!

Emergency Contact and References

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Address

Emergency Contact Relationship

Click on the Plus sign to add additional References.

Reference Name

Reference Phone Number

Reference Email Address

Reference Relationship

Reference Name

Reference Phone Number

Reference Email Address

Reference Relationship

Who is your emergency contact?: Required

Upload Resume and/or Cover Letter

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Are your able to pass a pre-employment drug test?: Required

Authorization

By clicking "Send" below, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, any falsified statements on this application shall be grounds for dismissal. Under the provisions of the Fair Credit Reporting Act, the Americans With Disabilities Act, the Drivers Privacy Protection Act and all other applicable federal, state, and local laws I authorize investigation of all statements contained herein as well as authorize the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise.

I hereby release and hold harmless any person, firm, or entity that discloses information in accordance with this authorization, as well as my prospective employer, and its agents, from any liability that may otherwise result from the request for, use of, or disclosure of, any or all of the foregoing information. The above-mentioned investigations may include, but are not limited to, information as to my character, general reputation, work history, or lifestyle, discerned through employment and education verifications; personal references; personal interviews; my personal credit history based on reports from any credit bureau; my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history records; or any other public record.

I understand that consumer reports which may contain public record information may be requested, at the discretion of my prospective employer, which may include names, dates of employment, reason for termination, work experience, traffic records, workers compensation claims, etc. I have the right, under the provisions of the Fair Credit Reporting Act and the Drivers Privacy Protection Act to request all such information from the reporting agency, upon proper identification, and to request the nature and substance of all information; and the receipt of any reports on me, which the reporting agency has, or will, furnish for the two preceding years. I am also entitled to a copy of my consumer rights under the Fair Credit Reporting Act. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.

* I hereby agree and consent to completing this application and background investigation process electronically. I understand that I will be signing this application and all forms related to this application electronically and that the electronic signatures appearing on these documents are the same as my handwritten signature for the purposes of validity, enforceability and admissibility. You have the right to withdraw your consent to sign electronically at any time by calling the number listed at the top of this page. You can print and retain a copy of any electronically signed documents by clicking on the PDF symbol in the top right corner of that document. * I hereby agree and consent to receiving SMS text messages requesting additional information and/or providing additional instructions regarding the application process, onboarding and/or my employment, if applicable. You have the right to withdraw your consent to receiving SMS text messages at any time by texting “STOP” in reply to any message you receive or by calling 888-209-7427.

As part of the application process we require that the following standard consent forms be completed. You do not have to fill these forms out. They will be automatically completed using the information you provided above. Please review each form in its entirety. After reading each form check the box next to it indicating your intention to sign and submit it along with your application.

This certifies that this application was completed by me and that all entries and the information herein are true and complete to the best of my knowledge.

Print Name * Required

Signature *

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Date: 2024-12-22 01:27:50

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Previous Employer	Prospective Employer	Prospective Employer's Agent
Company : Individual : Address : City : State : Zip :	Company : Apex Transportation Individual : Dennis Atencio Address : 9800 Alton Way City : Henderson State : CO Zip : 80640	Company : Individual : Address : City : State : Zip :

TYPE OF BUSINESS:	CONTACT:
1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates	a. Consumer Financial Protection Bureau 1700 G Street, N.W. Washington, DC 20552
b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:	b. Federal Trade Commission Consumer Response Center 600 Pennsylvania Avenue, N.W. Washington, DC 20580
2. To the extent not included in item 1 above: a. National banks, federal savings associations, and federal branches and federal agencies of foreign banks	a. Office of the Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050
b. State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and Insured State Branches of Foreign Banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act.	b. Federal Reserve Consumer Help Center P.O. Box 1200 Minneapolis, MN 55480
c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations	c. FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106
d. Federal Credit Unions	d. National Credit Union Administration Office of Consumer Financial Protection (OCFP) Division of Consumer Compliance Policy and Outreach 1775 Duke Street Alexandria, VA 22314
3. Air carriers	Asst. General Counsel for Aviation Enforcement & Proceedings Aviation Consumer Protection Division Department of Transportation 1200 New Jersey Avenue, S.E. Washington, DC 20590
4. Creditors Subject to the Surface Transportation Board	Office of Proceedings, Surface Transportation Board Department of Transportation 395 E Street, S.W. Washington, DC 20423
5. Creditors Subject to the Packers and Stockyards Act, 1921	Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies	Associate Deputy Administrator for Capital Access United States Small Business Administration 409 Third Street, S.W., Suite 8200 Washington, DC 20416
7. Brokers and Dealers	Securities and Exchange Commission 100 F Street, N.E. Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations	Farm Credit Administration 1501 Farm Credit Drive McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Listed Above	Federal Trade Commission Consumer Response Center 600 Pennsylvania Avenue, N.W. Washington, DC 20580 (877) 382-4357

TYPE OF BUSINESS:

CONTACT:

1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates

a. Consumer Financial Protection Bureau 1700 G Street, N.W. Washington, DC 20552

b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:

b. Federal Trade Commission Consumer Response Center 600 Pennsylvania Avenue, N.W. Washington, DC 20580

2. To the extent not included in item 1 above:
a. National banks, federal savings associations, and federal branches and federal agencies of foreign banks

a. Office of the Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050

b. State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and Insured State Branches of Foreign Banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act.

b. Federal Reserve Consumer Help Center P.O. Box 1200 Minneapolis, MN 55480

c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations

c. FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106

d. Federal Credit Unions

d. National Credit Union Administration Office of Consumer Financial Protection (OCFP) Division of Consumer Compliance Policy and Outreach 1775 Duke Street Alexandria, VA 22314

3. Air carriers

Asst. General Counsel for Aviation Enforcement & Proceedings Aviation Consumer Protection Division Department of Transportation 1200 New Jersey Avenue, S.E. Washington, DC 20590

4. Creditors Subject to the Surface Transportation Board

Office of Proceedings, Surface Transportation Board Department of Transportation 395 E Street, S.W. Washington, DC 20423

5. Creditors Subject to the Packers and Stockyards Act, 1921

Nearest Packers and Stockyards Administration area supervisor

6. Small Business Investment Companies

Associate Deputy Administrator for Capital Access United States Small Business Administration 409 Third Street, S.W., Suite 8200 Washington, DC 20416

7. Brokers and Dealers

Securities and Exchange Commission 100 F Street, N.E. Washington, DC 20549

8. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations

Farm Credit Administration 1501 Farm Credit Drive McLean, VA 22102-5090

9. Retailers, Finance Companies, and All Other Creditors Not Listed Above

Federal Trade Commission Consumer Response Center 600 Pennsylvania Avenue, N.W. Washington, DC 20580 (877) 382-4357

Non-CDL

Non CDL

*If at current address less than 5 years, list below most recent addresses for the past 5 years. (Click on the Plus sign to add additional Previous Addresses.)

Driver's Licence or State ID

Additional Licenses

General Information

Yes No

Yes No

Fulltime Partime

Yes No

Education

Employment History

You must provide accurate dates of employment and phone numbers for past employers. We cannot hire you without verifying employment. If you need to list additional employers, click "Add Another Employer" below.

Emergency Contact and References

Click on the Plus sign to add additional References.

Upload Resume and/or Cover Letter

Authorization

Authorization to contact current employer?

Driver Name :
Signature :		Date :

*If at current address less than 5 years, list below most recent addresses for the past 5 years. (Click on the Plus sign to add additional Previous Addresses.)

Yes No

Yes No

Fulltime Partime

Yes No

You must provide accurate dates of employment and phone numbers for past employers. We cannot hire you without verifying employment. If you need to list additional employers, click "Add Another Employer" below.

Click on the Plus sign to add additional References.

Applicant Authorization Consent For Release of Information

Applicant Authorization Consent For Release of Information Form

Please provide the following information as well as addresses for the last seven (7) years.

Authorization to contact current employer?

Other Disclosure and Authorization

Apex Transportation

OTHER DISCLOSURES, ACKNOWLEDGMENTS & AUTHORIZATIONS REGARDING BACKGROUND INVESTIGATION FOR EMPLOYMENT PURPOSES

Acknowledgments & Authorization

ADDITIONAL STATE LAW NOTICE

Disclosure and Authorization

Apex Transportation

DISCLOSURE AND AUTHORIZATION REGARDING BACKGROUND INVESTIGATION FOR EMPLOYMENT PURPOSES

DISCLOSURE

AUTHORIZATION

Verification of Employment

Pre-Employment Controlled Substance Consent Form

Pre-Employment Controlled Substance Consent Form

Fair Credit Reporting Act Consumer Rights

A SUMMARY OF YOUR RIGHTS

UNDER THE FAIR CREDIT REPORTING ACT

Drivers Rights Pertaining to Release of Information under Regulation 391.23

Drivers have the following rights:

Drivers Rights Pertaining to Release of Information
under Regulation 391.23