~ Transporting And Delivering With Excellence ~ Since 1940 A Family Heritage, A Promising Future…….

Employment…

Employees at Wilson Brothers are offered a comprehensive Benifits Package including the following:

• Health Care Insurance
• Dental Insurance
• 401K Plan (With Company Match)
• Short Term Disability
• Paid Vacations
• Paid Holidays
• Drivers have assigned trucks

If you have an interest in becoming a part of our Team, click the adjacent link for a printable application.

Fill it out completely, then send to one of the following:

Wilson Brothers Milling And Trucking Co., Inc.
20412 NC HWY 902
Bear Creek, NC 27207

Fax (919) 837-2133

employment@wilsonbrotherstrucking.com

Due to Insurance Regulations, we require a minimum of three years CDL driving experience of all applicants in combinations with a good Driving Record.

WB Application

Driver Application

MINIMUM DRIVER QUALIFICATION INFORMATION

The purpose of this document is to determine whether or not the driver is qualified to operate motor carrier equipment according to the requirements of the Federal Motor Carrier Safety Regulations and the Company named above.

Instructions to Driver / Applicant

Please answer all questions. If the answer to any question is “No” or “None”, do not leave the item blank, but write “No” or “None”.
Date*
Position Applying For;*
- Company Driver
- Contract Driver
- Owner Operator
- Truck Shop Mechanic
- Truck Shop General Labo
First Name*
Middle Name
Last Name*
Phone Number*
Emergency Phone Number*
Age*
Date of Birth*
Social Security Number*
*The Age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.
Physical Exam Expiration Date:*
Current & Three Years Previous Addresses:
Current Address
From
To
1. Previous Address
From
To
2. Previous Address
From
To
3. Previous Address
From
To
Have you worked for this company before?*
- Yes
- No
If yes, give dates:*
Reason for leaving?*
Education History

Please select the highest grade completed:
Grade School:*
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
College:*
- 1
- 2
- 3
- 4
Post-Graduate:*
- 1
- 2
- 3
- 4
Employment History

Give a Complete Record of all employment for the past ten years, including any unemployment or self- employment, and all commercial driving experience for the past ten years.

1.
From
To
Present or Last Employer:*
Position Held
Address*
Street AddressCityZIP Code
Phone*
Reason for Leaving
Were you subject to the FMCSRs *while employed here?*
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?*
- Yes
- No
2.
From
To
Present or Last Employer:*
Position Held
Address*
Street AddressCityZIP Code
Phone*
Reason for Leaving
Were you subject to the FMCSRs *while employed here?*
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?*
- Yes
- No
3.
From
To
Present or Last Employer:*
Position Held
Address*
Street AddressCityZIP Code
Phone*
Reason for Leaving
Were you subject to the FMCSRs *while employed here?*
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?*
- Yes
- No
4.
From
To
Present or Last Employer:*
Position Held
Address*
Street AddressCityZIP Code
Phone*
Reason for Leaving
Were you subject to the FMCSRs *while employed here?*
- Yes
- No
Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?*
- Yes
- No
*The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone who operates a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) has a GVWR or weighs 10,001 pounds or more, (2) is designed or used to transport nine or more passengers, or (3) is of any size, used to transport hazardous materials in a quantity requiring placarding.
Driving Experience
Class of Equipment
- Straight Truck
- Tractor and Semi-trailer
- Tractor-two trailers
- Tractor-three trailers (triples)
- Other
Straight Truck
From To Approximate Number of Miles (Total)
Tractor and Semi-trailer
From To Approximate Number of Miles (Total)
Tractor-two trailers
From To Approximate Number of Miles (Total)
Tractor-three trailers (triples)
From To Approximate Number of Miles (Total)
Other
From To Approximate Number of Miles (Total)
Select the states operated in for the last five years:
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
- Armed Forces Americas
- Armed Forces Europe
- Armed Forces Pacific
List special courses/training competed:
(PTD/DDC, Haz Mat, etc.)
List any Safe Driving Awards you hold and from whom:
Accident Record for past three years (add rows if needed)
Date of Accident Nature of Accident. (Head on, rear end, upset, etc.) Location of Accident # of Fatalities # of People Injured
Traffic Convictions and Forfeitures for the last three years (other than parking violations) (add rows if needed)
Date Location Charge Penalty
Driver’s License (list each driver’s license held in the past three years) (add rows if needed)
State License # Type Endorsements Expiration Date
A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?..
- Yes
- No
B. Has any license, permit or privilege ever been suspended or revoked?
- Yes
- No
C. Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the job description)?
- Yes
- No
D. Have you ever been convicted of a felony*?
- Yes
- No
If the answers to A, B, C or D is “YES”, give details
* Disclosure of this information does not automatically exclude the driver from consideration
Personal References

List three persons for references, other than family members, who have knowledge of your Work History / Performance / Safety Record.
Name
Address
Phone
Name
Address
Phone
Name
Address
Phone
Wilson Brothers Employee Named For Referral Bonus
FirstLast
To Be Read*
- I have read and do agree
Great West Casualty Company does not provide legal advice to its customers, nor does it advise insureds on employment related issues, therefore the subject matter is not intended to serve as legal or employment advice for any issue(s) that may arise in the operations of its insureds. Legal advice should always be sought from the insured’s legal counsel. Great West Casualty Company shall have neither liability nor responsibility to any person or entity with respect to any loss, action or inaction alleged to be caused directly or indirectly as a result of the information contained herein.
It is agreed and understood that any misrepresentation given on this document shall be considered an act of dishonesty. It is agreed and understood that the motor carrier or his agents may investigate my background to ascertain any and all information of concern to commercial driving record, whether same is of record or not, And I release the employers and persons named herein from all liability for any damages on account of their furnishing such information. It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. This certifies that the above information was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
DRIVER’S RIGHTS PERTAINING TO RELEASE OF DRIVER INFORMATION UNDER REGULATION 391.23
Motor carriers have the responsibility to make the following investigations and inquiries with respect to each driver employed, other than a person who has been a regularly employed driver of the motor carrier for a continuous period which began before January 1, 1971.
- (a)(1) An inquiry into the driver’s driving record during the preceding three years to the appropriate agency of every State in which the driver held a motor vehicle operator’s license or permit during those three years; and,
- (a)(2) An investigation of the driver’s employment record during the preceding three years.
- (b) A copy of the driver record(s) obtained in response to the inquiry or inquiries to each State driver
  
  record agency as required must be placed in the Driver Qualification File within 30 days of the date the
  
  driver’s employment begins and be retained in compliance with 391.51.
- (c) Replies to the investigations of the driver’s safety performance history must be placed in the Driver
  
  Investigation History File within 30 days of the date the driver’s employment begins. This goes into
  
  effect after October 29, 2004.
- (d) Prospective motor carrier must investigate the information from all previous employers of the
  
  applicant that employed the driver to operate a CMV within the previous three years. This information must cover general driver identification and employment verification information, data elements as specified in 390.15 for accident involving the driver that occurred in the three-year period preceding the date of the employment application, and any accidents the previous employer may wish to provide.
- (e) Prospective motor carrier must investigate the information from all previous DOT regulated employers that employed the driver within the previous three years from the date of the employment application in a safety-sensitive function that required alcohol and controlled substance testing specified by 49 CFR Part 40.
  
  Drivers have the following rights:
1. The right to review information provided by previous employers.
2. The right to have errors in the information corrected by the previous employer and for that previous
  
  employer to re-send the corrected information to the prospective employer.
3. The right to have a rebuttal statement attached to the alleged erroneous information, if the previous
  
  employer and the driver cannot agree on the accuracy of the information.
Drivers who wish to review previous employer-provided investigative information must submit a written request to the prospective employer when applying or as late as 30 days after employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five business days of receiving the written request. If the driver has not arranged to pick up or receive the requested records within 30 days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived his/her request to review the records.

Drivers wishing to request correction of erroneous information in records must send the request for the correction to the previous employer that provided the records. After October 29, 2004, the previous employer must either correct and forward the information to the prospective motor carrier employer or notify the driver within 15 days of receiving the driver’s request to correct the data that it does not agree to correct the data. Drivers wishing to rebut information in records must send the rebuttal to the previous employer with instruction to include the rebuttal in the driver’s Safety Performance History.

~ Transporting And Delivering With Excellence ~ Since 1940 A Family Heritage, A Promising Future…….

Employment…

Driver Application

Instructions to Driver / Applicant

Current & Three Years Previous Addresses:

Education History

Employment History

1.

2.

3.

4.

Driving Experience

Accident Record for past three years (add rows if needed)

Traffic Convictions and Forfeitures for the last three years (other than parking violations) (add rows if needed)

Driver’s License (list each driver’s license held in the past three years) (add rows if needed)

Personal References

DRIVER’S RIGHTS PERTAINING TO RELEASE OF DRIVER INFORMATION UNDER REGULATION 391.23

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