EmailMe Form - MHT Application

Position *

Are you willing to relocate? We are Located near Atlanta, Georgia.

¿Estás dispuesto a mudarte? Estamos ubicados cerca de Atlanta, Georgia. *

Yes

No

When can you start?

Cuando Pede Empezar? *

MM / DD / YYYY

Today's Date/ Fecha de Hoy *

MM / DD / YYYY

How Did You Hear About Us?

Como Escucho de Nosotros?

Upload Resume Here. (Optional)

Sube su Resume Aqui.

Contact Information/ Información del contacto

Name/ Nombre *

First Last

Social Security/ Seguro Social *

Do not enter space or Dash. No ingrese espacios.

Re-Enter Social Security/ Seguro Social *

Do not enter space or Dash. No ingrese espacios.

Date of Birth/ Fecha de Nacimeinto *

MM / DD / YYYY

Mobile Phone

### - ### - ####

Email

Address / Direccion *

Street Address City State / Province / Region Postal / Zip Code

Driver's License Number/ Numero del Licencia de Conducir *

Expiration Date for CDL/ Fecha de Vencimiento

MM / DD / YYYY

In Case of Emergency/ En caso de Emergencia

Do not leave anything Blank.

Emergency Contact/ Contacto de Emergencia *

First Last

Please enter your closest relative, spouse, mother etc/ Por favor entre su familiar mas cercano, esposa, mader etc.

Phone *

### - ### - ####

General Questioning/ Preguntas Generales

Please select one immigration status. *

Do you have any physical condition which may limit your ability to perform the job applied for?

¿Tiene alguna condición física que pueda limitar su capacidad para realizar el trabajo solicitado? *

Yes

No

If Yes, Explain

Have you ever tested positive for drugs or alcohol as a commercial driver?

¿Alguna vez ha dado positivo por drogas o alcohol como conductor comercial? *

Yes

No

If Yes Explain,

Have you ever been denied a license or have a suspended or revoked license for any period of time?

¿Alguna vez le han negado una licencia o le han suspendido o revocado una licencia por algún período de tiempo? *

Yes

No

If Yes, Explain in Details

Initial CDL License Issue Date/

Fecha de emisión de la licencia CDL inicial *

MM / DD / YYYY

Enter the date here when you first receive your drivers license.

Upload Medical Card Here

Upload CDL License Here

Medical Card Expiration Date

Fecha de vencimiento de la tarjeta médica *

MM / DD / YYYY

Enter your Driving Medical CArd not you HealthCare Medical Card.

Ingrese su tarjeta médica de manejo, no su tarjeta médica de Salud.

Work History / Historial de trabajo

I. Company Name/ Nombre de Empresa *

I. Supervisor's Name/ Nombre de Supervisor *

First Last

I. Supervisor's Phone Number / Numero de Supervisor *

### - ### - ####

I. Employed From:

MM / DD / YYYY

I. Employed To:

MM / DD / YYYY

I. Are you still employed there? ¿Sigues empleado allí? *

Yes

Explain Why Not/ Explica Por Que No.

II. Company Name/ Nombre de Empresa *

II. Supervisor's Name/ Nombre de Supervisor *

First Last

II. Supervisor's Phone Number / Numero de Supervisor *

### - ### - ####

I. Employed From:

MM / DD / YYYY

I. Employed To:

MM / DD / YYYY

II. Are you still employed there? ¿Sigues empleado allí? *

Yes

Explain Why Not/ Explica Por Que No.

DOT Mandated Driver's Ackoledgement of Logs Program.

Programa de Reconocimiento de Registros del Conductor Obligatorio del DOT.

Please check that you understand and agree to the following Mandates and Company Rules. Verifique que comprende y acepta los siguientes Mandatos y Reglas de la Compañía. *

	I Agree
All Logs Must be turned in, including Off Duty logs.
Logs Must be totally completed as per DOT requirements including all compliance.
Copies of all supportive documentation such as fuel and toll receipts, BOL Must be turned in the Carrier for False Log Verification.

Please enter your initials here that you fully understand the above statement from the Department of Transportation. *

Stone Mountain Transport's Company Policy For Hand-Held Communications Devices

Política de empresa de Stone Mountain Transport para dispositivos de comunicación portátiles

No Electronic Devices will be used while operating vehicle.. No se utilizarán dispositivos electrónicos mientras se opera el vehículo. *

	I Agree
No Exceptions on any devices, cellphones, tablets, laptops, pda's, phone texting, Qualcomm or similar device.
If you decide to receive a call , find a safe location (Not on the shoulder of the highway) Park safely.
You can only speak on the phone while using hands fgree Bluethooth or Cable device, your hands must be free at all times.
If you have an emergency please call 911 first, make sure to be fully parked in a safe place (not on the shoulder of highway)

At Stone Mountain Transport we have zero Tolerance for any electronic device usage while operating a vehicle, please enter your initials here understanding the severity of this matter and consequences and you Agree to Drive Safe. *

Certification and Compliance with driver license requirements. Certificación y cumplimiento de los requisitos de la licencia de conducir. *

	I Agree
Possess Only One License: You as a commercial driver, may not pocess more than one motor vehicle operator's license
Notification of License Suspension, Revocation or cancellation, section 392.42 requires that you notify your employer. This notification must be in writing.

Please enter your initials here that you fully understand the above statement from the Stone Mountain Transportation. *

Stone Mountain Transport's Maintenance and Safety Policy Overview.

SMT strives to reach maximum Safety Ratings and Maintenance Records. *

	I Agree
I Agree to Conduct Certified DOT Inspections every 90 Days. I will take my vehicles to get certified by DOT inspector.
I Agree to Complete DVIR every day as mandate it by the DOT and i will also upload pictures of oil dip stick and colant level with every Pre-Trip Inspection.
I Agree to Complete a Tire Pressure Inspection and adjustment every two week to ensure security and reliability of vehicle. We accept Love's Tire Pass.
I Agree to Conduct all preventative maintenance on vehicles as mandate it by the DOT and my employer SMT. I will assure my vehicle is not past due on any services.

Banking Information

We only accept United States Banks, Please make sure to maintain a bank account during employment. We will not fund a bank account under another person's name. We do not pay Cash or Wester Union. Only Bank Accounts

Name of Bank *

Example: Chase, Bank of America, BB&T

Routing Number for ACH *

Make Sure to verify this information with your bank.

Account Number *

Make Sure to verify this information with your bank.

Re- Enter Account Number *

Make Sure to verify this information with your bank.

Endorsements and Experiences

CDL Endorsements (Please select Only the Ones you possess) *

Acknowledgement

Please Read the above Application Carefully.

Sign Here, Hold the Left Click and Draw. *

Clear

Sign Your Name Here.

I certify that all statements made on this application including my attached documents are true, complete and correct to the best of my knowledge.

I authorize an inquity with all references listed and investigation of all statements made in this application.

I authorize Stone Mountain Transports or it's affiliates and parteners to conduct background check and gather my consumer report history.