Job Application Personal InformationName:* First Last Address:* Street AddressCityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState / Province / RegionPostal / Zip CodePhone: Area Code - Phone Number Birth Date:01020304050607080910111213141516171819202122232425262728293031 / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 20162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901daymonthyearE-mail:Driver's License Issue Date01020304050607080910111213141516171819202122232425262728293031 / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 20162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901daymonthyearDriver's License Expiration Date01020304050607080910111213141516171819202122232425262728293031 / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / daymonthyearState* AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState / Province / RegionIs your license currently suspended, revoked or denied?*YesNoCommercial Driver's License A-B-C?YesNoIf Yes, do you have a valid medical card?YesNoAvailabilityAvailability: We are a team of professionals that must be prepared to meet the needs of our customers. There are often occasions when our customer needs to move after 5:00 pm and on weekends. Our drivers must be flexible to meet those needs.Monday6:00 AM - 8:00 PMAvailable until 10:00 PM or laterTuesday6:00 AM - 8:00 PMAvailable until 10:00 PM or laterWednesday6:00 AM - 8:00 PMAvailable until 10:00 PM or laterThursday6:00 AM - 8:00 PMAvailable until 10:00 PM or laterFriday6:00 AM - 8:00 PMAvailable until 10:00 PM or laterSaturday6:00 AM - 8:00 PMAvailable until 10:00 PM or laterSunday6:00 AM - 8:00 PMAvailable until 10:00 PM or laterAre you available to work both Saturdays and Sundays?YesNoBackgroundDo you currently have a High School Diploma or Equivalent?*YesNoAre you willing to participate in random drug screening?*YesNoHave you ever been convicted of a crime?*YesNoIf so, what kind?MisdeamenorFelonyIf you have been convicted of a crime, please explain?How much experience do you have in the industry?NoneLess than one yeartwo to four yearsfive years or moreDo you have the ability to lift over 100 pounds?YesNoQuestionsWhat would you do if?The truck breaks down?You have a dissatisfied customer? You have a Team Member Concern?You see, or have knowledge of, a team member take homeowners' property?You see, or have knowledge of, a team member violating Mover Dudes' drug/alcohol policy?A customer asks you a question that you're not 100% sure of the answer.The vision of Mover Dudes is "Moving communities. Creating Opportunities." We are highly involved in our communities. What opportunities do you see for Mover Dudes to support the organizations within our community?Attach ResumeAttach References:Please do the following math:Item Cost Move Price$722.00Fuel Surcharge$166.48Equipment$167.00Packing Material$150.00Packing Services$250.00Note: Customer deposit of $120.00 Total Move Price:Balance Due:How did you hear about the position? If you were referred by a friend, please give us their name.------------------SubmitReset Recaptcha Verification:
