Driver Application
Dakota Lines, Inc.
In compliance with Federal and State equal employment opportunity
laws, qualified applicants are considered for all positions without
regard to race, color, religion, sex, national origin, age,
marital status, or non-job related disability.
Position Applied For:  

Social Security:     
Last Name:     
First Name:     
State:    Zip:   
Email Address:     
Drivers License #:     
Date of Birth:     
(required for Commercial Drivers)
(Min. 23 years of age) 
Driving Experience:     
(Min. 2 years in the last 5 years)
Who referred you?   
Rate of pay expected?  
Is there any reason you may NOT be able to perform the functions of this job for which you have applied.
 If yes, explain  
To be read and signed by applicant
This certifies that this application in its entirety, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been made. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand also, that I am required to abide by all rules and regulations of Dakota Lines, Inc.
Date:   04/23/2018
Applicant's Typed Name:     
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