Application

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Driver Information

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  • Years Driving
  • 0 Years
  • < 1 Years
  • 1 - 2 Years
  • 2 - 3 Years
  • 3 - 4 Years
  • 4 - 5 Years
  • 5 -10 Years
  • 10+ Years
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  • State (DL)
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
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Address

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  • Select State
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
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Questionnaire

No wrong answer disqualifies employment!
Any violations last 3 years?
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Ever failed a drug test?
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Belly Dump Experience?
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Work 60 hrs. per week?
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Any accidents last 5 years?
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Have you ever had a DUI?
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Drive 13-speed manual?
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Willing to sleep in truck?
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Upload Documents

Please upload your documents here using the upload buttons below
Drivers License
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Medical Card
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Resume
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Comments

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I authorize Roughstock Inc. to do a complete background investigation in accordance with state and federal laws. I authorize my previous employers to release any information requested by Roughstock Inc. and hold them harmless of all liability from the release of said information.

I hereby request and authorize to cause to be conducted, at any time, an investigation of my background for employment purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reflect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information.I have completed this application of my own free will and hold harmless of all liability all companies, agents and associated parties for the use of this application.

I certify, under penalty of law, that I personally completed this application and that all of the information is true and correct to the best of my knowledge
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