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PSTC - Application for CDL Qualification (short - PG-E4)

Field Personnel Questionnaire

*Indicates Mandatory Field

First Name *This question is required.

Last Name *This question is required.

Street Address / Apt *This question is required.

City *This question is required.

State *This question is required.

Postal Code *This question is required.

Home Phone Number

Mobile Phone Number *This question is required.

Email Address *This question is required.

How did you hear about Perkins? *This question is required.

Radio
Newspaper
Workforce Center
Veterans Group

Referral
Social Media (Facebook, Twitter, LinkedIn, etc)
Other

Comments

Do you currently possess a valid Class A or Class B CDL? *This question is required.

Do you have a minimum of 2 years of verifiable driving experience within the last 5 years?

Experience consists in (check all that apply): *This question is required.

Flatbed / Stepdeck
Van

Multi-Axle
Other

What endorsements do you currently hold? *This question is required.

Doubles/Triples
HazMat
None

Do you have any moving violations within the last 3 years? *This question is required.

If Yes, please explain. *This question is required.

Please answer Yes or No to the following questions... *This question is required.

Space Cell	Yes	No
The position you are applying for has physical requirements including being able to lift 75 pounds and pass a rigorous DOT Physical by a company doctor. Are you able to lift 75 pounds and pass a physical? *This question is required
As a condition of employment, you will be required to pass a drug test. Are you able to pass a pre-employment drug test? *This question is required
Have you ever failed a company sponsored drug test? *This question is required
Are you afraid of heights? *This question is required
Do you currently have a Passport Book (not card)? *This question is required
Do you have the ability to enter into Canada? *This question is required
Do you have a Transportation Worker Identification Card (TWIC)? *This question is required

Computer History and Experience *This question is required.We want to understand the level of familiarity and experience you have with a variety of electronic devices and communication softwares. Please list other electronic capabilities you feel are worth sharing in the text box below.

Please rank each on a scale of 1 to 5.
1 = no experience
5 = excellent experience

	1	2	3	4	5
	Experience (1 being no experience, 5 being excellent)
Email functionality (send/receive/forward) *This question is required
Mobile Devices (Cell/Smart phones, etc) *This question is required

Comments

Do you have heavy haul experience? *This question is required.

If Yes, please explain... *This question is required.

What additional information can you provide us that places you above and beyond any other candidate that applies for this position? *This question is required.

We thank you for taking the time to complete this pre-employment application. Perkins STC is a cutting edge company that is looking for great candidates that are looking for not just a job but also a career. By pressing submit below you are certifying that the information provided is true and correct and authorize Perkins STC to conduct through background check which will include but not limited to criminal, moving violation, employment verification as well as E-Verify check. Perkins is an equal opportunity employer

Status

Department