Application for Employment

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Date of application

Position being applied for*

Date available to begin work*

Years of manual transmission experience*

Have you completed high school or an equivalent?*

DAI requires at least 1 year interstate experience driving at least 53' trailers to be considered for this position. If you have less than 1 year experience please apply for the entry level car hauler position.

Years of CDL driving*

Auto Transport years*

Name*

First Middle Last

Address*

Street Address City State ZIP Code

Hiring States*

You must live in or be planning to move to one of our network states to be considered for hire. These are ME, NH, VT, MA, RI, CT, NY, NJ, PA, DE, MD. Please confirm your intent to move to an in-network state to proceed.

I am moving to one of Diversified's in-network states and wish to be considered for hire.

Phone 1*

Phone 2

Email*

Driver's License Image Upload*

Max. file size: 3 MB.

Eligible for employment in the USA?*

Previously applied to DAI?

Driver's Lic # & State*

Resident # (NA if none)*

Temp Visa # (NA if none)*

Desired Weekly Work Hours*

Pay Expected*

Will you work overtime if asked?*

How did you hear about Diversified Automotive?*

Special training or skills we should know about (languages, machine ops, etc)*

Education

Highest Level School Type Attended (High School, etc)*

School Name & Location*

Course of Study*

Years Completed*

Did you graduate?*

Degree or Diploma Earned*

Military Experience

Branch of Service*

Special Duties & Training*

Month and Year of Induction*

Date of Final Discharge*

Rank at Final Discharge*

Employment History

Company 1

Start Date*

End Date*

Company Name*

Company City*

Company Phone*

Supervisor Name*

Job Title*

Reason for Leaving*

Company 2

Start Date*

End Date*

Company Name*

Company City*

Company Phone*

Supervisor Name*

Job Title*

Reason for Leaving*

Company 3

Start Date*

End Date*

Company Name*

Company City*

Company Phone*

Supervisor Name*

Job Title*

Reason for Leaving*

Consent for Pre-Hire Screenings

Diversified Automotive requires applicants for employment to be screened prior to being hired. Some of our pre-screening items require your consent. Below is an explanation of the consent forms that you will be asked to sign and submit.

SambaSafety – SambaSafety is a third-party provider that offers a variety of pre-screening services. Diversified Automotive currently only uses them to run your Motor Vehicle Record (MVR). Once employed, we utilize Samba for real-time license monitoring. While the consent form is extensive, be mindful that we must obtain a current MVR prior to hire. We will require you to upload a photo of your CDL license in order to process the MVR request.

PSP – Diversified will run a PSP report to see your roadside inspection (CSA) history.

FMCSA Drug Clearinghouse – After a successful interview, Diversified will request a query against your license in the FMCSA Drug Clearinghouse. If you do not have a login.gov account established, please do so prior to your interview and then register as a driver at the following site: Drug & Alcohol Clearinghouse - Clearinghouse Registration

SambaSafety Consent and PSP Disclosure & Authorization forms completed and sent in separate PDFs.

SambaSafety Consent

Date	Actions

There are no Consents.

PSP Disclosure & Authorization

Date	Actions

There are no Authorizations.

Non-Discrimination Notice

Prospective employees will receive consideration without discrimination because of race, creed, color, sex, sexual orientation, age, national origin, or handicap.

I have read and agree to Diversified's non-discrimination notice*

Yes

No

Applicant's Statement

By submitting this Application for Employment with Diversified Automotive, Inc, I hereby declare the information provided by me is true, correct, and complete to the best of my knowledge. I understand that if employed, any misstatement or omission of fact on this Application shall be considered cause for dismissal. I further understand that this Application is not (and is not intended to be) a contract for employment and I agree and understand that, if employed, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice to me and without any liability to the company.

I authorize investigation of all statements contained in this Application as may be necessary in arriving at an employment decision, including investigative consumer reports containing information through personal interviews with my neighbors, friends, and acquaintances, and other reports as described in this application. These reports may include information as to my character, general reputation, personal characteristics, and mode of living. In the event of my employment, I understand that I will be required to abide by all the rules and regulations of the Company.

I have read and agree to Diversified's applicant's statement*

Yes

No

Date of Your Consents and Agreements to the Above*

Applicant Signature*

By signing here I confirm my consents for Diversified Automotive's use of my submitted information for pre-hire screenings and attestations of truthfulness as to all the information contained in this Application for Employment.

Comments

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Education

Military Experience

Employment History

Company 1

Company 2

Company 3

Consent for Pre-Hire Screenings

Non-Discrimination Notice

Applicant's Statement

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ABOUT DIVERSIFIED AUTO

RESPONSIBLE SERVICE