Employment Application Form

CALCASIEU RENTALS CAREERS

Please be sure to fill out this form entirely.

If you have any trouble with the application or need assistance please email us at

[email protected]

All applications will be reviewed for accuracy so please answer all appropriate questions completely and accurately.

Personal Information

MM slash DD slash YYYY
Name(Required)
Current Address(Required)
State Issued(Required)
MM slash DD slash YYYY
High School Education(Required)
College Education(Required)
Do you currently use illegal drugs?(Required)
Ever failed any drug/alcohol test (Including Pre-EMP Tests)(Required)
Refused to take a drug/alcohol test(Required)
Have you been charged/convicted of a felony and/or misdemeanor/or served time(Required)
Have you ever been convicted of a felony?(Required)
Have you ever been convicted of a misdemeanor?(Required)
Do you have any warrants or pending charges at this time?(Required)
May we contact your current employer?(Required)

READ AND SIGN THE STATEMENT BELOW

BY MY SIGNATURE BELOW, l AUTHORIZE YOU TO CONDUCT SUCH INVESTIGATIONS AND INQUIRY OF MY PERSONAL EMPLOYMENT, MEDICAL, DRIVING, ACCIDENT/INJURY, AND SUBSTANCE ABUSE TESTING REPORTS FROM MY CURRENT (IF CHECKED ABOVE) AND PREVIOUS EMPLOYERS AS MAY BE NECESSARY TO ARRIVE AT A QUALIFICATION DECISION. I UNDERSTAND THAT ANY OMISSSION OF INFORMATION OR MAKING FALSE A STATEMENT ON THIS OR ANY OTHER HIRING DOCUMENT CAN AND WILL LIKELY MEAN THAT I WILL NOT BE ALLOWED TO CONTINUE THE PROCESS. l ALSO UNDERSTAND THAT SHOULD I BE ALREADY WORKING UNDER THE DIRECTION OF CALCASIEU RENTALS WHEN SUCH OMISSION OR FALSE STATEMENT IS UNCOVERED, l MAY BE TERMINATED IMMEDIATELY, FOR CAUSE.
READ AND SIGN THE STATEMENT BELOW(Required)

Employment Record

List employers, starting with the most recent, working backwards. LEAVE NOTHING BLANK. The employer is the company who paid you and issued a w-2 or 1099 at the end of the year. If you did not work between employers, list those gaps in time by filling out a section with the word “unemployed” for Company Name. CDL drivers must list all driving history for previous 10 years.

Most Recent Employer

Are you currently working for this employer?(Required)
If yes, may we contact?(Required)
Address(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
Was this a DOT regulated position (job) that was subject to Alcohol and Drug testing requirements under CFR part40?(Required)

Second Most Recent Employer

Address(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
Was this a DOT regulated position (job) that was subject to Alcohol and Drug testing requirements under CFR part40?(Required)

Third Most Recent Employer

Address(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
Was this a DOT regulated position (job) that was subject to Alcohol and Drug testing requirements under CFR part40?(Required)

Work Experience

Please list the number of years of experience you have with each of the following
Years of experience
Years of experience
Years of experience

Driving Record

Do you have a minimum of 2 years verifiable driving experience?(Required)
No more then 2 preventable accidents in the last 3 years?(Required)
Accident Dates, Location, Name of Accident: (Such as Fatalities, Injuries, Violation)
No more then 2 moving violations in the past 3 years (including suspensions, DUI, reckless, etc)?(Required)
Date of violation, Location Type of Violation: (If no violations enter none and do not list parking violations.)

Medical

No history of Medical Disqualifying conditions(Required)
Do you have a valid DOT Medical Certification?(Required)

Other Verification

Do you have a valid CDL with Tank endorsement?(Required)
Do you have a valid TWIC card?(Required)
Must be a minimum of 23 years old to apply.(Required)

Certification & Release

BY MY SIGNATURE BELOW, l AUTHORIZE YOU TO CONDUCT SUCH INVESTIGATIONS AND INQUIRY OF MY PERSONAL EMPLOYMENT, MEDICAL, DRIVING, ACCIDENT/INJURY, AND SUBSTANCE ABUSE TESTING REPORTS FROM MY CURRENT (IF CHECKED ABOVE) AND PREVIOUS EMPLOYERS AS MAY BE NECESSARY TO ARRIVE AT A QUALIFICATION DECISION. I UNDERSTAND THAT ANY OMISSSION OF INFORMATION OR MAKING FALSE A STATEMENT ON THIS OR ANY OTHER HIRING DOCUMENT CAN AND WILL LIKELY MEAN THAT I WILL NOT BE ALLOWED TO CONTINUE THE PROCESS. l ALSO UNDERSTAND THAT SHOULD I BE ALREADY WORKING UNDER THE DIRECTION OF CALCASIEU RENTALS WHEN SUCH OMISSION OR FALSE STATEMENT IS UNCOVERED, l MAY BE TERMINATED IMMEDIATELY, FOR CAUSE.
Certification & Release(Required)