Name____________________________________  Social Security #_________________

Address_____________________________________________________________________

City__________________________________  State_________  Zip_________________

Telephone #_______________________________  Date of Birth___________________


                       DRIVER'S LICENSE INFORMATION

License #_________________________  State_______  Expiration Date___________

Have you ever had your license suspended or revoked? If yes, when___________

Please explain______________________________________________________________

Class A CDL? Yes______  No______   Attend driving school? Yes______ No______ 

Which one?_________________________________ Where___________________________

# of moving violations in last 3 years____  # of accidents last 3 years_____
  
Ever had a DUI/DWI, Careless or Reckless? Yes___ No___ If yes, when?________

Ever been convicted of a crime? Yes____  No____  If yes, when?______________


                  PLEASE LIST THREE YEARS EMPLOYMENT HISTORY

Dates of Employment: From________________________  To_______________________

Employer Name_______________________________________________________________

Address______________________________  City___________________  State_______

Telephone #__________________ Type of trailer_____________  # of States_____

Reason for Leaving__________________________________________________________


Dates of Employment: From________________________  To_______________________

Employer Name_______________________________________________________________

Address______________________________  City___________________  State_______

Telephone #__________________ Type of trailer_____________  # of States_____

Reason for Leaving__________________________________________________________


Dates of Employment: From________________________  To_______________________

Employer Name_______________________________________________________________

Address______________________________  City___________________  State_______

Telephone #__________________ Type of trailer_____________  # of States_____

Reason for Leaving__________________________________________________________



I certify that I personally completed this application for the purpose of employment and that all
the information herein is true and correct.  I authorize Ogletree Trucking Co., Ltd. to do a
complete background investigation in accordance with federal and state laws.  I authorize Ogletree
Trucking Co., Ltd. to complete a criminal background search.  I authorize my previous employers to
release any information requested by Ogletree Trucking Co., Ltd. and hold them harmless of all
liability from the release of said information.  I authorize release of any information, including
all information related to my alcohol and controlled substances testing and training records, by
any former employers and hold them harmless of any liability from release of said information.






Signature_______________________________________________  Date______________