Driver Application

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Education History

  • Employment History

  • Please list out dates worked, position held, Name, Address, Phone and reason for leaving
  • Please list out dates worked, position held, Name, Address, Phone and reason for leaving
  • Please list out dates worked, position held, Name, Address, Phone and reason for leaving
  • Driving Experience

  • Personal References

  • List out 3 persons for references, other than family members, who have knowledge of your safety habits. (list Name, Address and Phone)
  • To Be Read and Agreed by Applicant

    I authorize Nationwide Rail Services to make investigations and inquiries to my personal, employment, mvr, 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 extended.). 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(s) may result in discharge.  I understand, also, that I am required to abide by all rules and regulations of the Company.

    "I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety and performance history as required by 49 CFR 391.23(d) and (e).  I understand that I have the right to:

    • Review information provided by current/previous employers;
    • Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
    • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information."
  • Date Format: MM slash DD slash YYYY
  • Application Signature

    This certifies that I completed this application and that all entries on it and information in it are true and complete to the best of my knowledge.