MAINTENANCE TECHNICIAN APPLICATION

PERSONAL INFORMATION


Education

EMPLOYMENT HISTORY

PERSONAL REFERENCES

IT IS AGREED AND UNDERSTOOD THAT ANY MISREPRESENTATION GIVEN ON THIS APPLICATION SHALL BE CONSIDERED AN ACT OF DISHONESTY.

IT IS AGREED AND UNDERSTOOD THAT THE MOTOR CARRIER OR THEIR AGENTS MAY INVESTIGATE THE APPLICANT’S BACKGROUND TO ASCERTAIN ANY AND ALL INFORMATION OF CONCERN TO APPLICANT’S RECORD, WHETHER SAME IS OF RECORD OR NOT, AND APPLICANT RELEASES EMPLOYERS AND PERSONS NAMED HEREIN FROM ALL LIABILITY FOR ANY DAMAGES ON ACCOUNT OF THEIR FURNISHING SUCH INFORMATION.

IT IS ALSO AGREED AND UNDERSTOOD THAT UNDER THE FAIR CREDIT REPORTING ACT, PUBLIC LAW 91-508; I HAVE BEEN TOLD THAT THIS INVESTIGATION MAY INCLUDE AN INVESTIGATING CONSUMER REPORT, INCLUDING INFORMATION REGARDING MY CHARACTER, GENERAL REPUTATION, PERSONAL CHARACTERISTICS, AND MODE OF LIVING.

I AGREE TO FURNISH SUCH ADDITIONAL INFORMATION AND COMPLETE SUCH EXAMINATIONS AS MAY BE REQUIRED TO COMPLETE MY APPLICATION FILE.

IT IS AGREED AND UNDERSTOOD THAT THIS APPLICATION FOR QUALIFACATION IN NO WAY OBLIGATES THE MOTOR CARRIER TO EMPLOY OR HIRE THE APPLICANT.

IT IS AGREED AND UNDERSTOOD THAT IF QUALIFIED AND HIRED, I MAY BE ON A PROBATION PERIOD DURING WHICH TIME I MAY BE DISQUALIFIED WITHOUT RECOURSE.

THIS CERTIFIED THAT THIS APPLICATION WAS COMPLETE BY ME, AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

BY PRINTING BELOW I AGREE AND UNDERSTAND THAT ABOVE STATEMENTS.