Apply as Driver — EPTI | Extra Plus TX Inc.

01 Applicant Information

First Name*

Middle Name

Last Name*

Phone*

Email*

Date of Birth*

Social Security # *

Your SSN is required for driver background and safety history checks under 49 CFR 391.23, and is stored with restricted access.

Date of Application

Position Applied For*

Date Available for Work

Legal Right to Work in the U.S.?*

Yes No

02 Residency History (Past 3 Years)

Current Address

Street*

City*

State*

ZIP*

Years at Address

Mailing Address (if different from current)

Street

City

State

ZIP

03 License Information

I certify I do not hold more than one motor vehicle operator's license (49 CFR 383.21).

Current License

State*

License #*

Type / Class*

Expiration Date*

Endorsements

Ever denied a license, permit, or privilege to operate a vehicle?*

Yes No

Ever had a license/permit suspended or revoked?*

Yes No

If yes to either, explain

04 Driving Experience

05 Accident Record (Past 3 Years)

I have had an accident in the past 3 years

06 Traffic Convictions & Forfeitures (Past 3 Years)

Excluding parking violations.

I have had a traffic conviction in the past 3 years

07 Employment History

List all employment for the last 3 years. If you've driven commercially before, list 10 years total. Explain any employment gaps over 1 month.

08 Education

09 Other Qualifications

Anything else we should consider?

10 Certification

I authorize EPTI to investigate my personal, employment, financial, and medical history as necessary for an employment decision, and I release employers, schools, and other persons from liability in responding to such inquiries. I understand false or misleading information may result in discharge, and that my employment history will be used and verified as required by 49 CFR 391.23. I understand my rights to review, correct, and rebut information provided by previous employers. I certify that all entries on this application are true and complete to the best of my knowledge.

I have read and agree to the statement above*

Applicant Full Name (typed signature)*

Date*

By submitting, you certify the information above is true and complete.

✓

Application Received

Thanks for applying to drive with EPTI. We'll review your info and reach out if there's a match. Check your inbox for a confirmation email — if you don't see it, check your spam/junk folder, as it can occasionally land there.

Driver Employment Application

Application Received