Mountain River Trucking Inc. 207 Direct Lane Mount Airy, NC. 27030         Online Employment Application Fill in ALL spaces, leaving nothing blank. When finished, click on submit to send. We will be contacting you shortly. Thank you for choosing Mountain River Trucking Inc. View a printable version of our application here. PERSONAL INFORMATION Date Of Application: Last Name:   First:   Middle: You must give a full name Drivers License Number:   State Issued In: Street Address:   Years At Present Address: City:     State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY     Zip Code: Home Phone:   Business Phone:   Extension: Social Security No:   Birth Date: Have You Ever Applied For Employment With Us?       If Yes, When:   Position Desired:   You Are Applying For What Position? West Coast OTR Local Other When Will You Be Available To Begin Work? How Did You Learn Of Our Organization? EDUCATION COLLEGE Name/Location of School:   Degree/ When:   HIGH SCHOOL Name/Location of School:   Degree/ When:   OTHER Name/Location of School:   Degree/ When:    MILITARY Duties/Special Training:   Branch:     Period of Active Duty:     From:(month/year) Until:(month/year) EMPLOYMENT HISTORY (Please begin with the most recent employer) Employer 1 Name of employer:   Telephone: Address: Supervisor:   Job Title/Duties: Employed From: (month/year) Until: (month/year) Starting Weekly Pay: Ending Weekly Pay: Reason For Leaving: (Below) Employer 2 Name of employer:   Telephone: Address: Supervisor:   Job Title/Duties: Employed From: (month/year) Until: (month/year) Starting Weekly Pay: Ending Weekly Pay: Reason For Leaving: (Below) Employer 3 Name of employer:   Telephone: Address: Supervisor:   Job Title/Duties: Employed From: (month/year) Until: (month/year) Starting Weekly Pay: Ending Weekly Pay: Reason For Leaving: (Below) We may contact the employers above unless you indicate below those that you DO NOT want contacted: EXPERIENCE & QUALIFICATIONS Please list below any experience or qualifications you have pertaining to the job you're applying for: AGREEMENT In consideration of my employment, I agree to conform to the rules and regulations of Mountain River Trucking Inc., and my employment can be terminated, with or without cause and with or without notice, at any time, at the option of either the company or myself.   I understand that no manager or representative of the company, other than those authorized to do so by the company, has any authority to enter into any agreements for any special period of time, or to make any agreement contrary to the foregoing. I hereby authorize Mountain Rver Trucking Inc., the right to make a thorough investigation of my past employment, education, and activities, and I release from all liability all persons, companies and corporations supplying information.   I indemnify Mountain River Trucking Inc., against any liability which may result from making such investigation.   I understand that any false answer or statement or implication made by me in this application or other required document shall be considered cause for denial of employment or discharge. Additionally, I understand that nothing contained in this employment application or in the granting of an interview or being invited to take a physical, be road tested or allowed to attend a training class is intended to create an employment contract between Mountain River Trucking Inc., and myself for either employment or for the providing of any benefit.   No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon Mountain River Trucking Inc., unless made in writing.   If an employment relationship is established, I understand that I have the right to terminate my employment at any time and that Mountain River Trucking Inc., has the same right. By submitting this electronic application via the internet I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. In connection with my application for employment (including contract for services) with you, I understand that an investigative consumer report is being requested from DAC Services, Tulsa, Oklahoma, that will include information as to my character, work habits, performance and experience, along with reasons for termination of past employment from previous employers.   Further, I understand that you will be requesting information concerning my driving record and or information from various federal, state, and other agencies which maintain records concerning traffic offenses, accidents, etc., as well as information from DAC concerning (1) previous driving record requests made by others from such state agencies; (2) state provided driving records; (3) claims involving me in the files of insurance companies; (4) employment histories. I authorize, without reservation, any party or agency contacted by DAC to furnish the above-mentioned information. I have a right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.   I hereby consent to your obtaining the above information from DAC, and agree that such information which DAC has or obtains, and my employment history with you, if I am hired, will be supplied by DAC to other companies which subscribe to DAC's services. Do not submit this application unless you agree with the above statements.