Step 1 of 3 33% Benefits of driving for Premier: Health Care Coverage after 60 days 401k with match Home Weekly Out and back trips Stop pay Generous holiday and vacation pay Per mile pay based on driving experience Pay on all loaded and empty miles Per Diem Pay You can apply using the online form below, or click here for a downloadable PDF form or fill out the short form on our Contact page Online Application Call 616-594-5385 to speak with a recruiter directly. Applicant: please read and accept the following, prior to submitting this application for qualification. (A) The information you provide in this application, including but not limited to the information required by 49 CFR 391.21(b)(10)(11) below may be used, and your previous employers(s) will be contacted, for the purpose of investigating your safety performance history as required by 49 CFR 391.23(d)(e) and 49 CFR 40.25 (re: drug and alcohol information). (B) The prospective motor carrier, Premier Freight Systems, hereby notifies you that you have the following rights regarding the investigative information that will be provided to us pursuant to 49 CFR 391.23(d)(e): (1) The right to review information provide to us by previous employers/motor carriers; (2) The right to have errors in the information provided to us by the previous employer/motor carrier and for that previous employer/motor carrier to re-send the corrected information to Premier Freight Systems; (3) The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer/motor carrier and you cannot agree to the accuracy of the information. (C) EQUAL OPPORTUNITY EMPLOYER: In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, disability, and in Michigan, height, weight, and marital status. (D) I understand that if I have a protected handicap that effects my ability to perform the position, I may ask Premier Freight Systems to attempt to make accommodation as required by law. I must make my request in writing to Premier Freight Systems as soon as possible and no later than 182 days after the date I know or reasonably should know that accommodation is needed.I have read and accept the information above (check box)* I agree Applicant's Name* First Last Date of Birth* MM slash DD slash YYYY Yrs @ Address* Applicant's Current Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Are there currently any felony charges against you?* Yes No If "Yes," when?* MM slash DD slash YYYY Have you ever been convicted of any crime?* Yes No If "Yes," when?* MM slash DD slash YYYY Have you ever been known by any name other than the one on this application?* Yes No If "Yes" type name below.If "Yes" to any of the above, explain:*Are you:* a U.S. Citizen a Lawful Permanent Resident otherwise authorized to work in the United States Addresses at which Applicant has resided during the 3 years preceding date application submitted:Date range* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Date range Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Date range Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code In Case of Emergency notify:Name First Last Relationship Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneAre you able to perform the essential functions of the job for which you are applying with or without accommodation?* Who referred you? Have you worked for this company before?* Yes No If "Yes," Where? Dates worked (from / to) Rate of pay Position Reason for leaving Previous Employment: Information required by 49 CFR 391.21(b)(10)(11): Names and addresses of applicant's employers during the 10 years preceding date this application submitted; dates employed by, reason for leaving employment, whether applicant subject to Federal Motor Carrier Safety Regulations (FMCSRs), and whether job designated as safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing requirements as required by 49 CFR part 40 for each such employer. Previous employer information is also needed to comply with 49 CFR 40.25 and 391.23(e)(checking applicant's prior drug/alcohol test records) and/or required under authority of the Prospective Employer named in this application as part of its application process.Date hired* MM slash DD slash YYYY Date left* MM slash DD slash YYYY Last Employer Company Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Supervisor Name* First Last Position Held* Fleet Driver Owner-Operator Other Applicant was subject to FMCSRs while employed by above employer.* Yes No Job was designated as safety sensitive function in any DOT regulated mode subject to alcohol & controlled substances requirements of 49 CFR part 40.* Yes No Reason for Leaving* Salary In what states did you drive a CMV?* Date hired MM slash DD slash YYYY Date left MM slash DD slash YYYY Last Employer Company Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneSupervisor Name First Last Position Held Fleet Driver Owner-Operator Other Applicant was subject to FMCSRs while employed by above employer. Yes No Job was designated as safety sensitive function in any DOT regulated mode subject to alcohol & controlled substances requirements of 49 CFR part 40. Yes No Reason for Leaving Salary In what states did you drive a CMV? Date hired MM slash DD slash YYYY Date left MM slash DD slash YYYY Last Employer Company Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneSupervisor Name First Last Position Held Fleet Driver Owner-Operator Other Applicant was subject to FMCSRs while employed by above employer. Yes No Job was designated as safety sensitive function in any DOT regulated mode subject to alcohol & controlled substances requirements of 49 CFR part 40. Yes No Reason for Leaving Salary In what states did you drive a CMV? Date hired MM slash DD slash YYYY Date left MM slash DD slash YYYY Last Employer Company Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneSupervisor Name First Last Position Held Fleet Driver Owner-Operator Other Applicant was subject to FMCSRs while employed by above employer. Yes No Job was designated as safety sensitive function in any DOT regulated mode subject to alcohol & controlled substances requirements of 49 CFR part 40. Yes No Reason for Leaving Salary In what states did you drive a CMV? License and Permit Information for every State in which Driver held a commercial motor vehicle operator's license or permit during past 3 years:State License/Permit # Type Expiration Date MM slash DD slash YYYY State License/Permit # Type Expiration Date MM slash DD slash YYYY State License/Permit # Type Expiration Date MM slash DD slash YYYY List all violations of motor vehicle laws or ordinances (other than parking) of which applicant was convicted or forfeited bond or collateral during the 3 years preceding date application submitted:Date MM slash DD slash YYYY Location Charge Penalty Date MM slash DD slash YYYY Location Charge Penalty Date MM slash DD slash YYYY Location Charge Penalty Have you ever been disqualified under Federal Motor Carrier Safety Regulations guidelines?* Yes No Have you ever been convicted or are any charges pending for driving while under the influence of alcohol, a narcotic drug, amphetamines or methamphetamines or derivatives thereof?* Yes No Have you ever tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive trans- portation work covered by DOT agency drug and alcohol testing rules during the past three years?* Yes No Has any license, permit, or privilege to operate a motor vehicle issued to you ever been Denied?* Yes No Has any license, permit, or privilege to operate a motor vehicle issued to you ever been Revoked?* Yes No Has any license, permit, or privilege to operate a motor vehicle issued to you ever been Suspended?* Yes No If "YES" to any of the above, list dates and circumstances:*Driving ExperienceTruck Driving School Graduation Date MM slash DD slash YYYY Class/Type of Equipment (buses, trucks, truck tractors, semitrailers, full trailers, pole trailers)* Dates (from / to)* Approx Total Experience (yrs / mos)* Approx Total # Miles Driven* Class/Type of Equipment (buses, trucks, truck tractors, semitrailers, full trailers, pole trailers) Dates (from / to) Approx Total Experience (yrs / mos) Approx Total # Miles Driven List all motor vehicle accidents applicant involved in for 3 years preceding date application submitted:Date of Last Accident MM slash DD slash YYYY Nature of Accident (head-on, rear-end, upset, etc.) # Fatalities # Injuries Date of Next Previous Accident MM slash DD slash YYYY Nature of Accident (head-on, rear-end, upset, etc.) # Fatalities # Injuries # Injuries Date of Next Previous Accident MM slash DD slash YYYY Nature of Accident (head-on, rear-end, upset, etc.) # Fatalities # Injuries Driver Certification Includes all additional sheets. Indicate below if you have any questions that need to be answered on additional sheets. They can be turned into Premier at a later time.* Yes No If "Yes" list here* I understand that all employees of the Prospective Employer named in this application (Company) are employed on an indefinite basis and are subject to termination at any time, with or without notice, with or without prior discipline or warning, and with or without cause. No person other than the President of the Company has authority to offer employment for any specified period or to make any contract contrary to the statement of at-will employment. Moreover, no such agreement by the President will be enforceable unless the document is in writing, dated, and signed by the President. This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.Date* MM slash DD slash YYYY Applicant's Signature* First Last Background Report Authorization IMPORTANT DISCLOSURE REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with PREMIER FREIGHT SYSTEMS (“Prospective Employer”), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA). When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act. Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication. Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization. AUTHORIZATION If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize PREMIER FREIGHT SYSTEMS (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee. I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above. NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant’s written or electronic consent prior to accessing the Applicant’s PSP report. Further, account holders are required by FMCSA to use the language contained in this Disclosure and Authorization form to obtain an Applicant’s consent. The language must be used in whole, exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be included with other consent forms or any other language. AUTHORIZATION I hereby authorize Premier Freight Systems to obtain the consumer reports described above about me. I understand that these reports maybe run at any time during my employment with Premier Freight Systems.Applicant Name* First Last Date* MM slash DD slash YYYY
